老年女性高血压

高血压是老年女性心血管病发病率和死亡率的主要原因,老年女性高血压有其自身特点,如何管理与控制老年女性血压是临床医生面临的难题,及时诊断与适合的治疗方案可以有效减少心血管事件、终末期肾病、卒中等的发生风险。     

Characteristics of the blood serum lipoprotein pattern in female Tallinn residents aged 35-54 years.

In a single study of the female population aged 35-54 years in the city of Tallinn no significant differences in the blood lipoprotein pattern for the nationality (Estonian--Russian) and the phase of menstrual cycle in women with normal ovarian function were found. On the other hand, in comparison with those with a normal menstrual cycle postmenopausal women showed significantly higher levels of total cholesterol, triacylglycerols and low density lipoprotein cholesterol. For studies of risk factor prevalence of non-communicable diseases among female population, it is recommended, to identify women with menstrual cycle disturbance since their higher percentages could bias the results.     

Adenohypophysial dopamine content and prolactin secretion in the aged male and female rat

In male rats the concentrations of dopamine (DA) in the adenohypophysis and of PRL in serum increase progressively with age. The increase in the DA content is not a consequence of reduced metabolism of DA, since the activities of the enzymes that deaminate (monoamine oxidase) and O-methylate (catechol-O-methyltransferase) this amine are not reduced in the anterior pituitary of aged male rats; indeed, both type A and B monoamine oxidase activities are increased in the pituitaries of aged rats. The increased DA present in the aged adenohypophysis is not in a static pool but, as in young rats, is rapidly decreased by pharmacological treatments that reduce the activity of tuberoinfundibular DA neurons (gamma-butyrolactone), reduce the synthesis of DA in these neurons (alpha-methyltyrosine), or block DA receptors (haloperidol) in the adenohypophysis. All of these treatments increased serum PRL levels and reduced DA concentrations in the adenohypophysis of both young and aged rats. Similarly, in female rats, where age-related differences in BW and body composition are minimized, serum PRL concentrations and DA concentrations in the adenohypophysis of both young and aged rats changed in the same way after the administration of a DA agonist (apomorphine) or a DA antagonist (haloperidol). Apomorphine reversed the alpha-methyltyrosine-induced increase in serum PRL concentrations and the decrease in anterior pituitary DA content in both young and aged rats, although the latter animals appear to be more responsive to this drug. Similarly, aged rats were more sensitive to the increase in serum PRL concentrations and the decrease in anterior pituitary DA content caused by haloperidol. The actions of acute and chronically administered haloperidol are reversible, with the reduced DA content of the adenohypophysis and the elevated serum concentrations of PRL returning to respective pretreatment levels in both young and aged rats once treatment stops. The time course for recovery of serum PRL levels and anterior pituitary DA contents after both the acute and chronic haloperidol treatment is of longer duration in the aged rat, which is consistent with a decreased rate of clearance of haloperidol in these animals. Twelve daily injections of bromocriptine, a DA agonist, reduced serum PRL and anterior pituitary DA concentrations in both young and aged rats, and these effects persisted for up to 7 days after the injections were stopped.(ABSTRACT TRUNCATED AT 400 WORDS)     

Ovariectomy causes immunosenescence and oxi-inflamm-ageing in peritoneal leukocytes of aged female mice similar to that in aged males

Immunosenescence involves age-associated restructuring changes of innate and adaptative immune functions. We have suggested that these changes of the immune system participate in the rate of ageing through modulating oxi-inflamm-ageing. Thus, age-related changes in the immune system can be biological age markers and predictors of longevity. Gender differences in oxidation status and immune functions have been observed in rats, with males showing higher oxidation and immunosenescence than females of the same age. Oestrogens are sex hormones that actively participate in modulating the mammalian immune function and, therefore, the age-related impairment of the immune response is drastically accelerated in females during the menopausal transition. Ovariectomy in rodents constitutes a good model for mimicking human oestrogen loss and thus the menopausal situation. Recently, we have shown the deleterious effects of oestrogen loss on several functions of leukocytes from immune organs in rats and mice. In addition, ovariectomised rats show similar levels in these immune functions to those in males. The present work studied several functions as well as inflammatory and oxidative stress parameters in mouse peritoneal macrophages and lymphocytes from old sham and ovariectomised females, as well as in males of the same age. In general, the results show that females, which have a higher immune response and a lower oxidation and inflammation than males, appear similar to males in the parameters studied when they have lost oestrogens by ovariectomy. Thus, these data support the positive role of oestrogens in the immune function through the ageing process.     

70岁以上女性冠心病患者非体外循环冠状动脉旁路移植术

目的　分析总结 5 2例 70岁以上女性冠心病患者非体外循环冠状动脉旁路移植术。方法　 2 0 0 0年 8月至2 0 0 3年 9月共完成 5 2例 70岁以上女性冠心病患者非体外循环冠状动脉旁路移植术 ,平均年龄 (71.4± 1.7)岁。本组病例 ,不稳定型心绞痛 2 7例 ,1个月内急性心肌梗死 7例。冠状动脉 3支血管病变 4 7例 ,左主干病变 10例。 9例左心室射血分数低于 30 % ,10例左心室舒张期末内径大于 6 0 mm。结果　完成非体外循环冠状动脉旁路移植术 5 0例 ,包括急症手术 3例。 2例改为体外循环冠状动脉旁路移植术。平均远端血管吻合数 (2 .9± 1.2 )例。 4例使用主动脉气囊反搏。 1例术后 3周死于胸骨后感染所致多脏器功能衰竭。结论　非体外循环冠状动脉旁路移植术对 70岁以上女性患者是安全可行的。     

Lymphocyte reactivity in the aged.

Lymphocyte reactivity in cultures toward the nonspecific T and B cell mitogens, phytohemagglutinin (PHA) and pokeweed (PWM), was studied in 46 subjects in three groups: a) young healthy persons, b) elderly healthy persons, and c) hospitalized elderly patients with atherosclerotic cardiovascular disease. No statistically significant differences in the lymphocyte reactivity of young and old healthy persons toward PHA could be observed with different incubation times, mitogen concentrations, or serum sources. A significantly decreased lymphocyte response was found in elderly hospitalized patients compared to young and elderly healthy subjects. In contrast, no differences in the lymphocyte reactivity toward PWM could be found among the three groups, including a comparison between elderly healthy and elderly hospitalized persons. The results suggest that the B lymphocyte-dependent response to a B lymphocyte stimulator is more stable than is the T cell response in aged subjects.     

Sweat responses in the aged.

The sweating responses to thermal stimulation and to the intradermal injection of acetyl choline or methacholine were measured in 28 men and 18 women aged 70 and over and were compared with the responses in young control subjects of both sexes. There was found to be a marked reduction in the sweating activity of the majority of aged men in comparison with the younger age groups and the body temperature threshold for the onset of sweating was increased. The reduced response and elevated threshold were even more pronounced in aged females. There is considerable variability in response in different subjects and at different bodily sites. Impairment of thermoregulatory function due to diminished or absent sweating is thought to be one of the factors responsible for increased mortality in the elderly population during heat-waves.     

Klinefelter syndrome in the aged.

Three cases of Klinefelter syndrome diagnosed late in life are reported with the clinical and post-mortem findings. The diagnosis was suspected owing to the absence of testes and the presence of associated varied clinical features. The urinary follicle-stimulating hormone levels were not elevated and were very low in two of the cases. Bronchopneumonia, ascending pyelonephritis and cystitis were the main causes of death but there were varied pathological findings in the prostate of benign hyperplasia, carcinoma and prepubertal gland. Marked atherosclerosis of the aorta and the lower-limb vessels were present but the coronary systems were little affected. It is suggested that, because of the presence of two X chromosomes and the absence of testes, this condition may give a female pattern of longevity, many examples being overlooked in old age on account of inadequate clinical examination. Some support for this hypothesis will be found if its incidence in the aged is shown to be greater than in the young.     

Effects of chronic PGHS-2 inhibition on PGHS-dependent vasoconstriction in the aged female rat

OBJECTIVE: In menopause, aging and decreased estrogen levels are risk factors contributing to impaired vascular function. Previously, in a young ovariectomized rat model, we demonstrated an increase in prostaglandin H synthase (PGHS)-dependent vasoconstriction that could be prevented by estrogen replacement. Subsequently, we found that, with aging, estrogen acts through suppression of the PGHS-2 isoform. HYPOTHESIS: Chronic PGHS-2 inhibition reduces PGHS-dependent vasoconstriction in aging. METHODS: Ovariectomized, aged (12 months) Sprague-Dawley rats were treated with a placebo (n=7), or the PGHS-2 inhibitor (NS-398, s.c. 3 mg/kg) for 1 week (n=6) or 4 weeks (n=6). Methacholine (endothelium-dependent dilator) and phenylephrine (adrenergic constrictor) were used to assess vascular function in the absence or presence of the nonselective PGHS inhibitor, meclofenamate (1 micromol/l) or the specific PGHS-2 inhibitor NS-398 (10 micromol/l). RESULTS: One week of chronic PGHS-2 inhibition abolished a PGHS-dependent shift in methacholine-induced relaxation, while modulation was still observed in phenylephrine constriction. Surprisingly, 4 weeks of PGHS-2 inhibition enhanced PGHS-dependent modulation of vasoconstriction (P<0.05). PGH2/thromboxane inhibition (U-51605, 50 micromol/l) mimicked the results observed with PGHS inhibition among the groups. PGHS-2 expression increased with chronic PGHS-2 inhibition compared to control (P<0.05). CONCLUSIONS: Our data indicate a paradoxical increase in PGHS-dependent vasoconstriction and PGHS-2 expression with prolonged inhibition of PGHS-2 activity. Hence, inhibitors of PGHS-2 activity may not be beneficial in counteracting the vascular dysfunction seen with aging and menopause.     

Induced ovulation in aged female rats by L-dopa implants into the medial preoptic area

Direct placement of L-dopa into the medial preoptic area (MPOA) of aged pseudopregnant or constant vaginal estrous female rats resulted in a reinitiation of vaginal cycles and ovulation. Similar treatment with L-dopa in the dorsomedial septum or cortex was ineffective. Direct placement of leucine into any of the three brain regions did not have an effect on ovarian function. Intermittent treatment with L-dopa to MPOA was found to reinstate and maintain vaginal cycles in constant estrous females only when administered on the day of vaginal estrus of successive cycles. These findings support the hypothesis that age-dependent disturbances in ovarian function may be initiated by changes in neurotransmitter metabolism within the central nervous system.     

Partner preferences in different aged female rhesus macaques (Macaca mulatta)

It has been suggested that there is a strong age-peer preference for social partners among aged human and nonhuman primates. The purpose of this investigation was to study the social pairings that occurred in a large (70 animal) social group of rhesus macaques. Six females in each of three age classifications (old, prime, and young adults) were observed during a breeding season and nonbreeding season to determine with whom these individuals interacted in socially affiliative ways. The study group was housed in a 38 X 38 m outdoor area and only naturally occurring interactions were observed. The results suggest strong cross-age partner preferences that affect the distribution of socially affiliative responses within the group. There was a strong preference for kin in all classes except prime aged sisters. Among nonkin only the infants were consistently preferred as target animals for socially affiliative responses.     

踝臂指数与老年女性冠状动脉粥样硬化程度的相关性研究

目的探讨踝臂指数与老年女性冠状动脉粥样硬化程度的相关性。方法选择232例老年女性,根据冠状动脉造影检查结果分为对照组(38例)、单支病变组(46例)、2支病变组(65例)、3支或左主干病变组(3支病变组,83例),进行踝臂指数的测量、病史采集及血脂检查。结果与对照组和单支病变组比较,2支病变组和3支病变组患者踝臂指数明显降低(P0.01);单支病变组与对照组踝臂指数比较,差异无统计学意义(P=0.319);踝臂指数与Gensini评分呈显著负相关(r=-0.487,P=0.001)。结论踝臂指数与老年女性冠状动脉粥样硬化病变程度密切相关,有助于评估冠状动脉狭窄程度。     

Curcumin improves spatial memory and decreases oxidative damage in aged female rats

Aging induced cognitive impairment has been well documented for many years and several antioxidant strategies have been developed against this impairment. Curcumin is the active component of curcuma longa and has shown antioxidant, antiinflamatory and neuroprotective properties. We hypothesized that curcumin would have an influence on cognitive functions in aged female rats. The purpose of the present study was to investigate the effects of curcumin supplementation on cognitive impairment evaluated by Morris water maze (MWM) as well as the oxidative stress induced by aging in female rats. Rats were randomly divided into either control or curcumin-supplemented groups. Curcumin or vehicle (corn oil) were given once daily for a period of 12 days, beginning 7 days prior to and 5 days during the behavioral tests. Behavioral assessment was performed in MWM. At the end of the behavioral test, blood samples and brain tissues were taken for the analysis of malondialdeyde (MDA), protein carbonyl and glutathione levels. During the training session, curcumin supplementation decreased latency to reach to the platform and the total distance traveled. During the probe trial, curcumin supplementation increased the number of platform crossings. In addition to the behavioral testing, biochemical results showed that MDA levels decreased in brain tissue by curcumin supplementation. It may be concluded that, curcumin supplementation improves cognitive functions by decreasing the lipid peroxidation in brain tissue of aged female rats.