Sex differences in control of cutaneous blood flow.

Abstract

Women are far more likely than men to suffer from Raynaud's disease. The purpose of this study was to determine whether there are gender differences in local or central control of cutaneous blood flow that could account for the increased incidence of Raynaud's disease in women. To assess cutaneous blood flow, hand blood flow (HBF), finger blood flow (FBF), or skin perfusion (SP) was measured by fluid plethysmography, mercury strain-gauge plethysmography, or laser Doppler spectroscopy, respectively, in 47 volunteers. Basal HBF in men exceeded that of women (12.1±2.0 versus 6.2±1.5 mlU100 ml/min). Likewise, FBF in men surpassed that of women (19.5±4.1 versus 7.7±1.8 ml/100 mlVmin). Similarly, SP in men was greater than that of women (270±42 versus 81±16 perfusion units). However, after total body warming (to induce a thermal sympatholysis), HBF in women exceeded that of men, suggesting that the lower basal HBF in women was due to increased sympathetic outflow to the extremities. Mental stress and deep inspiration reduced HBF and SP in men. Paradoxically, both of these maneuvers increased HBF and SP in women. To determine whether these paradoxical responses in women were due to the women's elevated basal sympathetic tone, these experiments were repeated after total body cooling in men to increase sympathetic tone and after total body warming in women to reduce sympathetic tone. Total body cooling reduced HBF and SP in men. Under these conditions, mental stress and deep inspiration induced vasodilation. In women, total body warming for 10 minutes increased HBF. Under these conditions, mental stress and deep inspiration induced vasoconstriction. In conclusion, basal cutaneous blood flow is reduced in women. This appears to be due to a basal increase in sympathetic tone rather than to a local structural or functional difference in the cutaneous circulation. In addition, a paradoxical vasodilation in response to mental arithmetic and deep inspiration is unmasked at high levels of sympathetic tone. The gender differences in cutaneous blood flow may account for the increased incidence of Raynaud's disease in young women. (Circulation 1990;82:1607-1615

Finger skin cooling on contact with cold materials: an investigation of male and female responses during short-term exposures with a view on hand and finger size

“…Bollinger and Schlumpf (1976) found a lower rate of arterial inflow through the fingers in women than in men and that arterial inflow in response to cooling decreases more greatly in women than in men causing cooler limb temperatures. Cooke et al (1990) found finger blood flow to be more than double in men than women and skin perfusion more than triple. However, whilst changes in blood flow have been found to affect starting finger skin temperature before finger-pad contact cooling, the cooling behaviour of the finger skin during contact is not affected by differences in blood flow to the finger for contact forces above that of capillary pressure, typically 2.6-3.3kPa (20-25 mmHg) (Jay and Havenith, 2004b).…”

The influence of preoperative pharmacotherapy on the appearance of postoperative atrial fibrillation in patients undergoing isolated coronary artery bypass grafting

“…Sex-based differences in AF occurrence include differences in the expression of ion channels, hormonal effects on autonomic tone, and in myocardial architecture or fibre orientation. 9,10,11,12 There were no significant differences between the groups considering other preoperative factors (HTA, DM, COPD, preoperative TIA/CVI, PAD and smoking) in POAF vs. non-POAF patients. Arterial hypertension was present in 60% of patients with AF in the Framingham Study.…”

Sex Difference in Peripheral Arterial Response to Cold Exposure

“…Regarding sex differences in the control of cutaneous vascular flow, basal hand blood flow is reduced in women compared with men as measured by laser Doppler flowmetry and plethysmography. 17 This appears to be caused by a basal increase in sympathetic tone rather than to a local structural or functional difference in cutaneous circulation. That may also account for our finding that the tissue temperature of females pre cold exposure was lower than in males.…”