title: Estrogen status and the renin angiotensin aldosterone system.
abstract: The renin-angiotensin-aldosterone system (RAAS) is integrally involved in multiple cardiovascular physiological processes including arterial blood pressure (BP) regulation. Over activity of the RAAS has been implicated in the pathogenesis of a number of cardiovascular disease entities, including hypertension. Several lines of evidence suggest estrogen favorably modulates the RAAS. Conversely, estrogen deficiency due to menopause may contribute to over activity of the RAAS. Of importance, estrogen deficiency in women is not exclusive to the postmenopausal period. Functional hypothalamic amenorrhea is a reversible cause of premenopausal hypoestrogenemia. In contrast to postmenopausal women (PMW), premenopausal women with exercise-associated functional hypothalamic amenorrhea demonstrate decreased, not increased, resting BP compared with their estrogen-replete eumenorrheic counterpart. In this review we briefly examine the effects of estrogen status on the RAAS and present the hypothesis that the RAAS is altered in physically active women with functional hypothalamic amenorrhea.
authors.affiliation: University Health Network and Mount Sinai Hospital, Division of Cardiology, Department of Medicine, University of Toronto, Canada; and emma.odonnell@utoronto.ca.
authors.forename: Emma
authors.initials: E
authors.lastname: O'Donnell
authors.affiliation: University Health Network and Mount Sinai Hospital, Division of Cardiology, Department of Medicine, University of Toronto, Canada; and.
authors.forename: John S
authors.initials: JS
authors.lastname: Floras
authors.affiliation: Division of Cardiology, Women's College Hospital, Department of Medicine, University of Toronto, Canada.
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Harvey
mesh_terms: D000568:Amenorrhea / Q000503:physiopathology; D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D004967:Estrogens / Q000502:physiology*; D005260:Female; D006801:Humans; D009043:Motor Activity / Q000502:physiology*; D017697:Premenopause / Q000502:physiology; D012084:Renin-Angiotensin System / Q000502:physiology*
chemical_list: D004967:Estrogens
keywords: amenorrhea; energy deficiency; estrogen; exercise; ovarian disruption