Oral contraceptive use, muscle sympathetic nerve activity, and systemic hemodynamics in young women
Open accessAbstract
Endogenous female sex hormones influence muscle sympathetic nerve activity (MSNA), a regulator of arterial blood pressure and important factor in hypertension development. Although ≈80% of American women report using hormonal contraceptives sometime during their life, the influence of combined oral contraceptives (OCs) on MSNA and systemic hemodynamics remains equivocal. The goal of this study was to determine whether women taking OCs have altered MSNA and hemodynamics (cardiac output and total peripheral resistance) at rest during the placebo phase of OC use compared with women with natural menstrual cycles during the early follicular phase. We retrospectively analyzed data from studies in which healthy, premenopausal women (aged 18-35 years) participated. We collected MSNA values at rest and hemodynamic measurements in women taking OCs (n=53; 25±4 years) and women with natural menstrual cycles (n=74; 25±4 years). Blood pressure was higher in women taking OCs versus those with natural menstrual cycles (mean arterial pressure, 89±1 versus 85±1 mm Hg, respectively; P=0.01), although MSNA was similar in both groups (MSNA burst incidence, 16±1 versus 18±1 bursts/100 heartbeats, respectively; P=0.19). In a subset of women in which detailed hemodynamic data were available, those taking OCs (n=33) had similar cardiac output (4.9±0.2 versus 4.7±0.2 L/min, respectively; P=0.47) and total peripheral resistance (19.2±0.8 versus 20.0±0.9 U, respectively; P=0.51) as women with natural menstrual cycles (n=22). In conclusion, women taking OCs have higher resting blood pressure and similar MSNA and hemodynamics during the placebo phase of OC use when compared with naturally menstruating women in the early follicular phase.
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Claims the paper makes
11 of 39 cited sources checked · 4 supported · 0 flagged · accuracy not yet measured
- Premisecitation
Most studies have found no difference in resting muscle sympathetic nerve activity between the active-hormone pill phase and the placebo pill phase of oral contraceptive use.
“Most studies have noted that there is no difference in human sympathetic nerve activity (measured as muscle sympathetic nerve activity; MSNA) at rest between the active-hormone pill phase and placebo pill phase of OC use.7–9”
Quote in the paperSubstantial claim1 of 3 sources checked - Interpretationreasoning
Muscle sympathetic nerve activity during the placebo phase of oral contraceptive use does not equate to muscle sympathetic nerve activity during the early follicular phase of the natural menstrual cycle.
“This suggests that MSNA during the placebo phase does not equate to MSNA reported during the early follicular phase of the natural menstrual cycle.”
Quote in the paperSubstantial claim1 of 4 sources checked- cites [7] source
- cites [8] source
The Discussion (page unavailable) contrasts MSNA responses across oral-contraceptive phases with those reported across natural menstrual phases, supporting the suggestion that the phases are not interchangeable. But the study did not directly compare MSNA in the placebo phase with MSNA in the natural early follicular phase, so it does not establish that their MSNA levels differ. (LLM, conf=0.82)
Experimental — accuracy not yet measured - cites [9] source
- cites [13] source
- Premisecitation
Oral contraceptive use increases the risk of developing hypertension.
“In addition to increased risk of arterial and venous thrombosis, one of the most common consequences is increased blood pressure with an elevated risk for the development of hypertension.3”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [3] source
The section “Contracepção hormonal e hipertensão arterial sistêmica (HAS)” reports that combined oral contraceptives raise blood pressure by an average of 2–3 mmHg in healthy women. It adds that most do not need antihypertensive treatment; it does not establish an increased risk of developing hypertension. The claim extends the reported blood-pressure increase to a clinical diagnosis. (LLM, conf=0.86)
Experimental — accuracy not yet measured
- Premisecitation
Muscle sympathetic nerve activity is higher during the luteal phase than during the follicular phase in women with natural menstrual cycles.
“This finding is analogous to the higher levels of MSNA seen during the luteal phase versus the follicular phase of women with natural menstrual cycles.7, 11, 12”
Quote in the paperSubstantial claim1 of 3 sources checked - Premisecitation
Muscle sympathetic nerve activity is greater in young men and older postmenopausal women than in young women.
“First, MSNA is greater in young men and older postmenopausal women in comparison to young women,14”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [14] source
The Results (page unavailable) report higher MSNA in postmenopausal women than in young women, supporting that comparison. They also report no difference in MSNA between young men and young women before β-blockade, contrary to the other comparison. (LLM, conf=0.91)
Experimental — accuracy not yet measured
- Premisecitation
Physiological concentrations of progesterone can oppose estrogen's vasodilating effects on the endothelium.
“For example, physiological concentrations of progesterone can oppose estrogen’s vasodilating effects on the endothelium when measured via flow-mediated dilation.48”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [48] source
The Discussion and Conclusions (page not provided) report that adding oral progesterone abolished estradiol’s improvement in endothelial function measured by flow-mediated dilation in young healthy women. The Results report elevated progesterone levels during supplementation, but the paper does not establish that those levels were physiological concentrations; the finding is specific to short-term oral administration. (LLM, conf=0.84)
Experimental — accuracy not yet measured
- Premisecitation
An acute increase in diastolic or mean arterial blood pressure of 3-5 mmHg is usually experimentally sufficient to abolish muscle sympathetic nerve activity in healthy young subjects.
“In this context, an acute increase in diastolic or mean arterial blood pressure of 3–5 mmHg is usually experimentally sufficient to abolish MSNA in healthy young subjects.50, 51”
Quote in the paperSubstantial claim1 of 2 sources checked- cites [50] source
The Methods (Data Analysis; page unavailable) report that higher diastolic pressure is associated with a lower likelihood of MSNA bursts in healthy young subjects. The Discussion (Relevance of calculations; page unavailable) limits the findings to resting conditions, not an acute experimental pressure increase. It does not establish that a 3–5 mmHg rise in diastolic or mean arterial pressure usually abolishes MSNA. (LLM, conf=0.88)
Experimental — accuracy not yet measured - cites [51] source
- Findingown data
There was no correlation between muscle sympathetic nerve activity and total peripheral resistance in either oral contraceptive users or non-users (non-OC: r=0.11, p=0.63; OC: r=0.21, p=0.23).
“nor was there any correlation between MSNA and TPR in either group (non-OC: r=0.11, R2=0.012, p=0.63; OC: r=0.21, R2=0.044, p=0.23).”
Quote in the paperNot a substantial claim - Findingown data
In the subset with intra-arterial blood pressure measurement, total peripheral resistance was similar between oral contraceptive users and non-users (19.2±0.8 vs 20.0±0.9 units, p=0.51).
“and total peripheral resistance (19.2±0.8 vs. 20.0±0.9 units, respectively; p=0.51) as women with natural menstrual cycles”
- Also stated in: § Results · plain
“All variables were found to be similar between the two groups (SV: p=0.94; CO: p=0.47; TPR: p=0.51; Table 3).”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data
Heart rate did not differ between oral contraceptive users and non-users (p=0.69).
“Heart rate was not different between the two groups (p=0.69).”
Quote in the paperNot a substantial claim - Findingown data
Resting systolic blood pressure was higher in oral contraceptive users than in non-users (p<0.001).
“Systolic (p<0.001), diastolic (p=0.05), and mean (89±1 vs. 85±1 mmHg, respectively; p=0.01) arterial pressures were greater in women taking OCs versus non-OC women.”
Quote in the paperSubstantial claim - Findingown data
In healthy premenopausal women aged 18-35, resting mean arterial pressure was higher in combined oral contraceptive users than in women with natural menstrual cycles studied during the early follicular phase (89±1 vs 85±1 mmHg, p=0.01).
“Blood pressure was higher in women taking OCs versus those with natural menstrual cycles (mean arterial pressure: 89±1 vs. 85±1 mmHg, respectively; p=0.01)”
- Also stated in: § Results · plain
“Systolic (p<0.001), diastolic (p=0.05), and mean (89±1 vs. 85±1 mmHg, respectively; p=0.01) arterial pressures were greater in women taking OCs versus non-OC women.”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data
A subanalysis by oral contraceptive formulation (monophasic, diphasic, triphasic) showed no differences in blood pressure, muscle sympathetic nerve activity, or heart rate.
“Additionally, in our data set, a subanalysis by OCP formulation (monophasic, diphasic, vs. triphasic) showed no differences in blood pressure, MSNA and heart, suggesting that these OCP types do not have differential effects in this particular group of women”
Quote in the paperNot a substantial claim - Findingown data
Resting muscle sympathetic nerve activity burst incidence was similar between oral contraceptive users and non-users (16±1 vs 18±1 bursts/100 heartbeats, p=0.19).
“although MSNA was similar in both groups (MSNA burst incidence: 16±1 vs. 18±1 bursts/100 heartbeats, respectively, p=0.19)”
- Also stated in: § Results · plain
“There were no significant differences in MSNA burst frequency (10±1 vs. 11±1 bursts/minute, respectively; p=0.25) or MSNA burst incidence (16±1 vs. 18±1 bursts/100 heartbeats, respectively; p=0.19) between OC and non-OC women (Figure 1).”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data
Resting pulse pressure was higher in oral contraceptive users than in non-users (p<0.01).
“Pulse pressure (p<0.01) was also higher in women taking OCs.”
Quote in the paperNot a substantial claim - Findingown data
Similar trends were observed for the associations between muscle sympathetic nerve activity burst frequency and mean arterial pressure, cardiac output, and total peripheral resistance.
“Similar trends were observed between the associations of MSNA burst frequency and MAP, CO, and TPR.”
Quote in the paperNot a substantial claim - Findingown data
Women taking drospirenone-containing oral contraceptives tended to have lower mean arterial pressure than women taking other oral contraceptives (83±3 vs 90±1 mmHg, p=0.06).
“there was a tendency for women taking drospirenone-containing OCs to have a lower MAP than women taking other types (n=46) of OCs (83±3 vs. 90±1 mmHg, p=0.06).”
Quote in the paperNot a substantial claim - Findingown data
There was no relationship between muscle sympathetic nerve activity burst incidence and mean arterial pressure in women taking oral contraceptives (r=0.21, R2=0.044, p=0.13).
“while there was no relationship between these variables in women taking OCs (r=0.21, R2=0.044, p=0.13).”
Quote in the paperSubstantial claim - Findingown data
In the subset with intra-arterial blood pressure measurement, cardiac output was similar between oral contraceptive users and non-users (4.9±0.2 vs 4.7±0.2 L/min, p=0.47).
“those taking OCs (n=33) had similar cardiac output (4.9±0.2 vs. 4.7±0.2 L/min, respectively; p=0.47)”
- Also stated in: § Results · plain
“All variables were found to be similar between the two groups (SV: p=0.94; CO: p=0.47; TPR: p=0.51; Table 3).”
Quote in the paperNot a substantial claim - Also stated in: § Results · plain
- Findingown data
There was a weak positive correlation between muscle sympathetic nerve activity burst incidence and mean arterial pressure in women with natural menstrual cycles (r=0.27, R2=0.073, p=0.02).
“There was a weak, but significant, positive correlation between these two variables in women with natural menstrual cycles (r=0.27, R2=0.073, p=0.02)”
Quote in the paperNot a substantial claim - Findingown data
In the subset with intra-arterial blood pressure measurement, stroke volume was similar between oral contraceptive users and non-users (p=0.94).
“All variables were found to be similar between the two groups (SV: p=0.94; CO: p=0.47; TPR: p=0.51; Table 3).”
Quote in the paperNot a substantial claim - Findingown data
There was no correlation between muscle sympathetic nerve activity and cardiac output in either oral contraceptive users or non-users (non-OC: r=-0.09, p=0.69; OC: r=-0.05, p=0.77).
“There was no correlation between MSNA and CO in either group of women (non-OC: r=−0.09, R2=0.008, p=0.69; OC: r=−0.05, R2=0.003, p=0.77)”
Quote in the paperNot a substantial claim - Findingown data
Resting muscle sympathetic nerve activity burst frequency was similar between oral contraceptive users and non-users (10±1 vs 11±1 bursts/min, p=0.25).
“There were no significant differences in MSNA burst frequency (10±1 vs. 11±1 bursts/minute, respectively; p=0.25) or MSNA burst incidence (16±1 vs. 18±1 bursts/100 heartbeats, respectively; p=0.19) between OC and non-OC women (Figure 1).”
Quote in the paperSubstantial claim - Findingown data
Resting diastolic blood pressure was higher in oral contraceptive users than in non-users (p=0.05).
“Systolic (p<0.001), diastolic (p=0.05), and mean (89±1 vs. 85±1 mmHg, respectively; p=0.01) arterial pressures were greater in women taking OCs versus non-OC women.”
Quote in the paperNot a substantial claim - Interpretationreasoning
The volume-expanding effects of oral contraceptives and their resulting effects on blood pressure appear to predominate.
“Taken together, the volume expanding effects of OCs and the resultant effects on blood pressure appear to predominate.”
Quote in the paperSubstantial claim0 of 3 sources checked - Interpretationreasoning
Oral contraceptive use limits the ability of baroreceptors to lower muscle sympathetic nerve activity when blood pressure is elevated.
“Because OCs are known to activate the renin-angiotensin-aldosterone system, our findings suggest that OC use limits the ability of baroreceptors to lower MSNA in the face of increased blood pressure.”
Quote in the paperSubstantial claim - Interpretationreasoning
In young women with natural menstrual cycles, large individual differences in muscle sympathetic nerve activity do not produce drastic changes in mean arterial pressure.
“That is, it is reasonable to conclude from both reports that, in young women with natural menstrual cycles, large individual differences in MSNA do not result in drastic changes in MAP.”
Quote in the paperSubstantial claim - Interpretationown data
Oral contraceptive use alters the overall relationship between blood pressure and muscle sympathetic nerve activity.
“This also suggests that OC use alters the overall relationship between blood pressure and MSNA.”
Quote in the paperSubstantial claim - Study design and conductreasoning
Detailed hemodynamic variables were unattainable for all women in the cohort because of methodological differences between sites.
“First, due to methodological differences between sites, detailed hemodynamic variables were unattainable for all women in our cohort.”
Quote in the paperNot a substantial claim - Premisecitation
Long-term use of combined oral contraceptives increases systolic blood pressure by about 8 mmHg on average in normotensive women.
“With long-term use of hormonal contraceptives, specifically combined oral contraceptives (OCs), systolic blood pressure has been shown to increase by ~8 mmHg on average in normotensive women4”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] source
- Interpretationown data
The findings may not extend to women of different races because the sample consisted of relatively lean, healthy Caucasian women.
“Finally, the women in the current study were all relatively lean, healthy Caucasians so our findings may not extend to women of different races.”
Quote in the paperNot a substantial claim - Premisecitation
Progestin-only pills have not been associated with increased blood pressure in normotensive women.
“Progestin-only pills have not been associated with increased blood pressure in normotensive women,42”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [42] source
- Premisecitation
Blood pressure does not decrease during the placebo phase of oral contraceptive use.
“which is in agreement with reports that blood pressure does not decrease during the placebo phase of OC use.13”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [13] source
- May combine two claims. 17
- Classified as probably not a substantial claim. 7
May combine two claims.
InterpretationcitationEndogenous female sex hormones influence blood pressure regulation, and their absence may modulate hypertension risk.
“These findings suggest that endogenous female sex hormones (estrogen and progesterone) influence blood pressure regulation and their absence may modulate hypertension risk.”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [14] source
- cites [15] source
The Conclusions and Perspectives suggest that female reproductive hormones affect blood-pressure regulation and that loss of estrogen-related effects may increase hypertension risk in postmenopausal women with high MSNA. The Discussion’s Limitations section says estrogen and progesterone were not measured; the proposed vascular mechanism concerns estrogen, so the paper does not specifically support an effect of progesterone. (LLM, conf=0.82)
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationIn young men and older postmenopausal women, there is a positive correlation between muscle sympathetic nerve activity and mean arterial pressure, as well as between muscle sympathetic nerve activity and total peripheral resistance.
“Conversely, in young men and older postmenopausal women, there is a positive correlation between MSNA and MAP, as well as MSNA and TPR.15”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [15] source
The Results report a positive MSNA–TPR correlation in young men but no MSNA–MAP correlation in men. The Perspectives say the MSNA–MAP relationship becomes positive with age, more so in women, but the paper does not establish a positive MSNA–TPR correlation in older postmenopausal women. (LLM, conf=0.90)
Experimental — accuracy not yet measured
Classified as probably not a substantial claim. May combine two claims.
PremisecitationHart et al. reported that young premenopausal women did not show a relationship between muscle sympathetic nerve activity and mean arterial pressure or between muscle sympathetic nerve activity and total peripheral resistance.
“Hart et al. reported that young premenopausal women (a cohort including some individuals taking OCs) did not demonstrate a relationship between MSNA and mean arterial pressure (MAP) or MSNA and total peripheral resistance (TPR).14”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [14] source
May combine two claims.
Findingown dataStroke volume was greater in women taking triphasic oral contraceptives than in those taking monophasic oral contraceptives (p<0.05), with no significant differences in cardiac output or total peripheral resistance.
“SV was significantly greater in women taking triphasic OCPs in comparison to women taking monophasic OCPs (p<0.05), but there were no significant differences in CO and TPR.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataPlasma norepinephrine and epinephrine levels did not differ between oral contraceptive users and non-users (p=0.65 and p=0.74, respectively).
“Plasma norepinephrine (p=0.65) and epinephrine (p=0.74) levels, available in 22 non-OC women and 29 OC women, did not differ between groups (Table 4).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataPlasma estradiol and progesterone levels did not differ between oral contraceptive users and non-users (p=0.65 and p=0.09, respectively).
“Plasma estradiol and progesterone levels, available in 43 non-OC women and 19 OC women, were not different between the two groups (p=0.65 and p=0.09, respectively).”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductcitationAll contributing laboratories are highly experienced and follow a standard human microneurography technique, with high intra-subject repeatability.
“However, all labs contributing material to this study are highly experienced and follow what might be called a standard technique for human microneurography, and thus, the intra-subject repeatability of the technique is very high.52”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [52] source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenAll investigators were blinded to oral contraceptive status during review and quantification of muscle sympathetic nerve activity data.
“All investigators were blinded to OC status during review and quantification of MSNA data.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductnone givenThe contributing studies followed similar protocols for microneurography technique and muscle sympathetic nerve activity analysis.
“These studies followed similar protocols in respect to microneurography technique and MSNA analysis.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductown dataIn the subset with intra-arterial blood pressure measurement, age differed between groups (27±1 vs 24±1 years, non-OC vs OC, p=0.03) while mean arterial pressure was similar (93±2 vs 91±2 mmHg, p=0.052).
“Of note, in this subset of women, age was different (27±1 vs. 24±1; non-OC vs. OC, respectively; p=0.03) and MAP was similar (93±2 vs. 91±2 mmHg; p=0.052) in the groups”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataIn the subset with intra-arterial blood pressure measurement, muscle sympathetic nerve activity differed between groups (22±2 vs 16±2 bursts/100 heartbeats, non-OC vs OC, p=0.03) but was similar after adjustment for age (p=0.11).
“By contrast MSNA was different (22±2 vs. 16±2 bursts/100 heartbeats; non-OC vs. OC, respectively; p=0.03), but similar after adjusting for age (p=0.11).”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataAge and body mass index did not differ between oral contraceptive users and non-users (p=0.60 and p=0.11, respectively).
“Age (p=0.60) and body mass index (p=0.11) were not different between the two groups.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductreasoningDuration and reason for oral contraceptive use were unknown and could introduce selection bias into the dataset.
“Other factors unknown to us about our sample include duration of OC use and reason for OC use, which could potentially input selection bias into our data set.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductreasoningThe women were taking a variety of oral contraceptive formulations, and the retrospective design prevented controlling for this variable.
“Third, the women in this study were taking a variety of OC formulations, and due to the retrospective nature of this project, we were unable to control for this variable.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataThe subset of women with detailed hemodynamic data had different characteristics from the overall group, including differences in age and muscle sympathetic nerve activity, but no differences in blood pressure.
“The subset of women in which hemodynamic variables were available had different characteristics than the overall group, including differences in age and MSNA, but no differences in blood pressure.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationA recent study suggested that muscle sympathetic nerve activity is greater during the active pill phase of oral contraceptive use.
“In contrast, a recent study has suggested that MSNA is greater during the active pill phase of OC use.10”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [10] source
May combine two claims.
PremisecitationOral contraceptives upregulate the renin-angiotensin-aldosterone system, increasing angiotensinogen, angiotensin II, aldosterone, plasma renin activity, and renal vascular resistance, resulting in increased blood pressure.
“OCs (combined estradiol and progesterone formulations) also are known to upregulate the renin-angiotensin-aldosterone system to increase angiotensinogen, angiotensin II, and aldosterone levels, as well as plasma renin activity and renal vascular resistance, resulting in increased blood pressure.45, 46”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
PremisecitationBoth endogenous estrogen and progesterone concentrations are relatively low during the early follicular phase and the placebo phase of oral contraceptive use.
“In addition, both endogenous estrogen and progesterone concentrations are relatively low during these stages, in contrast to the luteal phase, during which plasma estrogen concentrations are moderate and plasma progesterone concentrations are high.31–33”
Quote in the paperSubstantial claim0 of 3 sources checkedMay combine two claims.
PremisecitationEstrogens can promote systemic vasodilation via enhanced nitric oxide synthesis and can expand plasma volume.
“Female reproductive hormones (particularly estrogens) can promote both systemic vasodilation via enhanced nitric oxide synthesis (which would lower blood pressure) and expand plasma volume (which could increase blood pressure).44”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [44] source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe vaginal ring contraceptive has been associated with elevated diastolic and mean blood pressures.
“The vaginal ring contraceptive, for example, has been associated with elevated diastolic and mean blood pressures;41”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [41] source
May combine two claims.
PremisecitationDrospirenone has high antimineralocorticoid activity and promotes urinary loss of water and sodium, thereby reducing blood pressure.
“As discussed above, OCs containing the progestin drospirenone, which has high antimineralocorticoid activity, will promote urinary loss of water and sodium and thereby reduce blood pressure.49”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [49] source
The paper relies on this without support.
Previous studies on this topic have had small sample sizes.
“Additionally, sample sizes in previous studies have been small.”
The paper relies on this without support.
Higher concentrations of endogenous female sex hormones, particularly estrogen and progesterone, are protective to the cardiovascular system and reduce a young woman's risk of hypertension.
“Higher concentrations of endogenous female sex hormones, particularly estrogen and progesterone, are believed to be protective to the cardiovascular system and reduce a young woman’s risk of hypertension.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Cohort described as entirely Caucasian despite reported diversity
MinorThe limitations describe all participants as Caucasian, but the subjects section says approximately 4% were African-American, Asian, or Hispanic.
“Finally, the women in the current study were all relatively lean, healthy Caucasians so our findings may not extend to women of different races.”
“Approximately 96% of subjects were Caucasian and the remainder were either African-American, Asian, or Hispanic.”
Cites
Policy: NIH to balance sex in cell and animal studies
Clayton, J. A., & Collins, F. S. (2014) · Nature · doi:10.1038/509282a · Cited by 1,816 · see citing works
Hashimoto, M., Akishita, M., Eto, M., Ishikawa, M., Kozaki, K., Toba, K., Sagara, Y., Taketani, Y., Orimo, H., & Ouchi, Y. (1995) · Circulation · doi:10.1161/01.cir.92.12.3431 · Cited by 574 · see citing works
Minson, C. T., Halliwill, J. R., Young, T. M., & Joyner, M. J. (2000) · Circulation · doi:10.1161/01.cir.101.8.862 · Cited by 515 · cited 2× · see citing works
“This finding is analogous to the higher levels of MSNA seen during the luteal phase versus the follicular phase of women with natural menstrual cycles.(7,11,12) In general, studies on this topic are limited because they do not compare women taking OCs with a control group of women with natural menstrual cycles who are…”
ResultSelf-citationThe normal menstrual cycle in women
Mihm, M., Gangooly, S., & Muttukrishna, S. (2011) · Animal Reproduction Science · doi:10.1016/j.anireprosci.2010.08.030 · Cited by 448 · see citing works
Hart, E. C., Charkoudian, N., Wallin, B. G., Curry, T. B., Eisenach, J. H., & Joyner, M. J. (2009) · Hypertension · doi:10.1161/hypertensionaha.108.126391 · Cited by 349 · cited 5× · see citing works
“Earlier studies suggest that endogenous female sex hormones may modulate the relationship between these cardiovascular factors and decrease a young woman’s susceptibility to hypertension development.(14,15) However, the group of young women in the study by Hart et al(14) consisted of women with both natural menstrual…”
BackgroundInfluentialSelf-citationHart, E. C., Charkoudian, N., Wallin, B. G., Curry, T. B., Eisenach, J., & Joyner, M. J. (2011) · The Journal of Physiology · doi:10.1113/jphysiol.2011.212753 · Cited by 338 · cited 1× · see citing works
“Earlier studies suggest that endogenous female sex hormones may modulate the relationship between these cardiovascular factors and decrease a young woman’s susceptibility to hypertension development.(14,15) However, the group of young women in the study by Hart et al(14) consisted of women with both natural menstrual…”
BackgroundSelf-citation(2006) · Obstetrics & Gynecology · doi:10.1097/00006250-200606000-00055 · Cited by 277 · see citing works
Sex and gender differences in control of blood pressure
Maranon, R. O., & Reckelhoff, J. F. (2013) · Clinical Science · doi:10.1042/cs20130140 · Cited by 260 · cited 1× · see citing works
“Androgens can also influence this risk and should also be taken into consideration, as evidence suggests that elevated androgen levels in women may be detrimental to the cardiovascular and endocrine systems.(43) Simultaneously and somewhat paradoxically as noted above, it is known that OC use increases an individual’s…”
BackgroundOelkers, W., Foidart, J. M., Dombrovicz, N., Welter, A., & Heithecker, R. (1995) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.80.6.7775629 · Cited by 247 · cited 1× · see citing works
“In women who take these OC formulations, blood pressure does not change or may slightly decrease.(39,40) In our cohort, 6 women were taking such OCs at the time of being studied, and indeed, there was a tendency for women taking drospirenone-containing OCs to have a lower MAP than women taking other types (n=46) of OC…”
BackgroundOral Contraceptives: Renin, Aldosterone, and High Blood Pressure
Laragh, J. H. (1967) · JAMA · doi:10.1001/jama.1967.03130120026007 · Cited by 229 · cited 10× · see citing works
“OC-induced hypertension has been reported since the 1960s with the development of combined OCs.(1,37,38) These first-generation OCs contained much higher concentrations of estrogen (150 μg), in combination with a progestin, compared with more recent formulations (20–35 μg of estrogen plus a progestin); however, OCs co…”
BackgroundInfluentialPhysiological Changes Associated with the Menstrual Cycle: A Review
Farage, M. A., Neill, S., & MacLean, A. B. (2009) · Obstetrical & Gynecological Survey · doi:10.1097/ogx.0b013e3181932a37 · Cited by 189 · see citing works
<i>The Menstrual Cycle</i>: <i>Basic Biology</i>
Hawkins, S. M., & Matzuk, M. M. (2008) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1429.018 · Cited by 168 · see citing works
Sympathetic neural responses to 24-hour sleep deprivation in humans: sex differences
Carter, J. R., Durocher, J. J., Larson, R. A., DellaValla, J. P., & Yang, H. (2012) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.01132.2011 · Cited by 153 · see citing works
Self-citationWhy are sex and gender important to basic physiology and translational and individualized medicine?
Miller, V. (2014) · American Journal of Physiology. Heart and Circulatory Physiology · doi:10.1152/ajpheart.00994.2013 · Cited by 150 · see citing works
Menstrual cycle effects on sympathetic neural responses to upright tilt
Fu, Q., Okazaki, K., Shibata, S., Shook, R. P., VanGunday, T. B., Galbreath, M. M., Reelick, M. F., & Levine, B. D. (2009) · The Journal of Physiology · doi:10.1113/jphysiol.2008.168468 · Cited by 144 · see citing works
Self-citationSympathetic Activity and Baroreflex Sensitivity in Young Women Taking Oral Contraceptives
Minson, C. T., Halliwill, J. R., Young, T. M., & Joyner, M. J. (2000) · Circulation · doi:10.1161/01.cir.102.13.1473 · Cited by 139 · cited 3× · see citing works
“Data were retrospectively pooled from previous MSNA studies that took place at the following institutions: (1) Mayo Clinic, Rochester, MN; (2) Michigan Technological University, Houghton, MI (23); (3) Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, and University of Texa…”
MethodInfluentialSelf-citationORAL CONTRACEPTIVES AND HYPERTENSION
Woods, J. (1967) · The Lancet · doi:10.1016/s0140-6736(67)90690-3 · Cited by 131 · see citing works
The state of hormonal contraception today: established and emerging noncontraceptive health benefits
Maguire, K., & Westhoff, C. (2011) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2011.06.056 · Cited by 124 · cited 2× · see citing works
“Hormonal contraceptives, often prepared as ethinyl estradiol and progestin combinations, are known to have unfavorable effects on the cardiovascular system with chronic use.(2) In addition to increased risk of arterial and venous thrombosis, one of the most common consequences is increased blood pressure with an eleva…”
BackgroundAging Enhances Autonomic Support of Blood Pressure in Women
Barnes, J. N., Hart, E. C., Curry, T. B., Nicholson, W. T., Eisenach, J. H., Wallin, B. G., Charkoudian, N., & Joyner, M. J. (2013) · Hypertension · doi:10.1161/hypertensionaha.113.02393 · Cited by 121 · see citing works
Self-citationOral contraceptives and hypertension.
Woods, J. W. (1988) · Hypertension · doi:10.1161/01.hyp.11.3_pt_2.ii11 · Cited by 111 · see citing works
van Heusden, A. M., & Fauser, B. C. J. M. (1999) · Contraception · doi:10.1016/s0010-7824(99)00025-6 · Cited by 108 · cited 1× · see citing works
“In addition, the use of the same OC across all individuals does not guarantee that plasma estrogen and progesterone levels would be homogenous among the women, as pharmacokinetics and pharmacodynamics related to OCs may differ between individuals.(53) Importantly, a subanalysis of women on the 3 main formulations of O…”
ResultRegulation of angiotensinogen gene expression by estrogen
Gordon, M. S., Chin, W. W., & Shupnik, M. A. (1992) · Journal of Hypertension · doi:10.1097/00004872-199204000-00007 · Cited by 106 · cited 1× · see citing works
“The pathogenesis of OC-induced hypertension is thought to be mediated by the effects of estrogens on the renin–angiotensin– aldosterone system.(6) Because the sympathetic nervous system plays a vital role in blood pressure regulation, OCs may alter sympathetic control of blood pressure.”
BackgroundOvarian Cycle and Sympathoexcitation in Premenopausal Women
Carter, J. R., Fu, Q., Minson, C. T., & Joyner, M. J. (2013) · Hypertension · doi:10.1161/hypertensionaha.112.202598 · Cited by 105 · cited 2× · see citing works
“This finding is analogous to the higher levels of MSNA seen during the luteal phase versus the follicular phase of women with natural menstrual cycles.(7,11,12) In general, studies on this topic are limited because they do not compare women taking OCs with a control group of women with natural menstrual cycles who are…”
ResultSelf-citationEffect of oral contraceptives on the renin angiotensin system and renal function
Kang, A. K., Duncan, J. A., Cattran, D. C., Floras, J. S., Lai, V., Scholey, J. W., & Miller, J. A. (2001) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.2001.280.3.r807 · Cited by 103 · cited 1× · see citing works
“OCs (combined estradiol and progesterone formulations) also are known to upregulate the renin–angiotensin–aldosterone system to increase angiotensinogen, angiotensin II, and aldosterone levels, as well as plasma renin activity and renal vascular resistance, resulting in increased blood pressure.(45,46) Progesterone al…”
BackgroundInfluences of female reproductive hormones on sympathetic control of the circulation in humans
Charkoudian, N. (2001) · Clinical Autonomic Research · doi:10.1007/bf02332974 · Cited by 100 · cited 5× · see citing works
“Progestin-only pills have not been associated with increased blood pressure in normotensive women,42 and it is unknown whether they would be associated with changes in MSNA.”
BackgroundInfluentialSelf-citationWenner, M. M., & Stachenfeld, N. S. (2012) · The Journal of Physiology · doi:10.1113/jphysiol.2012.236752 · Cited by 97 · cited 1× · see citing works
“Progesterone alone, depending on the type of vessel and strength of exposure, may cause vasoconstriction or vasodilation.(47) For example, physiological concentrations of progesterone can oppose estrogen’s vasodilating effects on the endothelium when measured via flow-mediated dilation.”
BackgroundCarter, J. R., Lawrence, J. E., & Klein, J. C. (2009) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00019.2009 · Cited by 87 · see citing works
Self-citationOral contraceptives. Renin, aldosterone, and high blood pressure
Laragh, J. H. (1967) · JAMA · doi:10.1001/jama.201.12.918 · Cited by 79 · see citing works
Contracepção hormonal e sistema cardiovascular
Brito, M. B., Nobre, F., & Vieira, C. S. (2011) · Arquivos Brasileiros de Cardiologia · doi:10.1590/s0066-782x2011005000022 · Cited by 78 · cited 1× · see citing works
“In addition to increased risk of arterial and venous thrombosis, one of the most common consequences is increased blood pressure with an elevated risk for the development of hypertension.(3) With long-term use of hormonal contraceptives, specifically combined oral contraceptives (OCs), systolic blood pressure has been…”
BackgroundLow‐dose oral contraceptives and 24‐hour ambulatory blood pressure
Cardoso, F., Polónia, J., Santos, A., Silva‐Carvalho, J., & Ferreira‐de‐Almeida, J. (1997) · International Journal of Gynecology & Obstetrics · doi:10.1016/s0020-7292(97)00239-7 · Cited by 73 · cited 1× · see citing works
“In general, studies on this topic are limited because they do not compare women taking OCs with a control group of women with natural menstrual cycles who are not taking OCs; and studies that have examined blood pressure in women before, during, and after OC use have not measured sympathetic nerve activity directly.(4…”
Effects of the menstrual cycle on sympathetic neural responses to mental stress in humans
Carter, J. R., & Lawrence, J. E. (2007) · The Journal of Physiology · doi:10.1113/jphysiol.2007.141051 · Cited by 71 · see citing works
Self-citationEnglish, J. L., Jacobs, L., Green, G., & Andrews, T. C. (1998) · The American Journal of Cardiology · doi:10.1016/s0002-9149(98)00322-1 · Cited by 71 · see citing works
Progesterone increases plasma volume independent of estradiol
Stachenfeld, N. S., & Taylor, H. S. (2005) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00031.2005 · Cited by 67 · cited 1× · see citing works
“OCs (combined estradiol and progesterone formulations) also are known to upregulate the renin–angiotensin–aldosterone system to increase angiotensinogen, angiotensin II, and aldosterone levels, as well as plasma renin activity and renal vascular resistance, resulting in increased blood pressure.(45,46) Progesterone al…”
BackgroundMiner, J. A., Martini, E. R., Smith, M. M., Brunt, V. E., Kaplan, P. F., Halliwill, J. R., & Minson, C. T. (2011) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00405.2011 · Cited by 66 · cited 1× · see citing works
“For example, physiological concentrations of progesterone can oppose estrogen’s vasodilating effects on the endothelium when measured via flow-mediated dilation.(48) It is important to note that synthetic progestins have activity not only at the progesterone receptor Table 3.”
BackgroundSelf-citationProgestogen-only pills and high blood pressure: is there an association?
Hussain, S. F. (2004) · Contraception · doi:10.1016/j.contraception.2003.09.002 · Cited by 65 · see citing works
Ambulatory blood pressure in mild hypertensive women taking oral contraceptives a case-control study
Narkiewicz, K., ROCCOGRANIERO, G., D'Este, D., Mattarei, M., Zonzin, P., & Palatini, P. (1995) · American Journal of Hypertension · doi:10.1016/0895-7061(95)96212-3 · Cited by 63 · cited 1× · see citing works
“With long-term use of hormonal contraceptives, specifically combined oral contraceptives (OCs), systolic blood pressure has been shown to increase by ≈8 mm Hg on average in normotensive women(4) and in women with mild hypertension before initiation of OC use.(5) The pathogenesis of OC-induced hypertension is thought t…”
BackgroundEffect of four combined oral contraceptives on blood pressure in the pill-free interval
Nichols, M., Robinson, G., Bounds, W., Newman, B., & Guillebaud, J. (1993) · Contraception · doi:10.1016/0010-7824(93)90034-5 · Cited by 57 · cited 2× · see citing works
“With the exception of 1 report,(10) studies have noted no difference in MSNA at rest between the placebo pill phase and active pill phase of OC use, which is in agreement with reports that blood pressure does not decrease during the placebo phase of OC use.(13) This suggests that MSNA during the placebo phase does not…”
ResultKimmerly, D. S., O'Leary, D. D., & Shoemaker, J. K. (2004) · Autonomic Neuroscience · doi:10.1016/j.autneu.2004.06.005 · Cited by 56 · see citing works
Blood Pressure Effects of the Oral Contraceptive and Postmenopausal Hormone Therapies
Boldo, A., & White, W. B. (2011) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2011.01.008 · Cited by 54 · cited 13× · see citing works
“OC-induced hypertension has been reported since the 1960s with the development of combined OCs.(1,37,38) These first-generation OCs contained much higher concentrations of estrogen (150 μg), in combination with a progestin, compared with more recent formulations (20–35 μg of estrogen plus a progestin); however, OCs co…”
BackgroundInfluentialDifferent cardiovascular effects of progestins according to structure and activity
Nath, A., & Sitruk-Ware, R. (2009) · Climacteric · doi:10.1080/13697130902905757 · Cited by 46 · cited 1× · see citing works
“As discussed above, OCs containing the progestin drospirenone, which has high antimineralocorticoid activity, will promote urinary loss of water and sodium and thereby reduce blood pressure.(49) Taken together, the volume expanding effects of OCs and the resultant effects on blood pressure seem to predominate.”
BackgroundEthinyl estradiol-to-desogestrel ratio impacts endothelial function in young women
Meendering, J. R., Torgrimson, B. N., Miller, N. P., Kaplan, P., & Minson, C. T. (2008) · Contraception · doi:10.1016/j.contraception.2008.07.025 · Cited by 45 · see citing works
Self-citationMiddlekauff, H. R., Park, J., & Gornbein, J. A. (2012) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00579.2011 · Cited by 44 · cited 1× · see citing works
“This finding is analogous to the higher levels of MSNA seen during the luteal phase versus the follicular phase of women with natural menstrual cycles.(7,11,12) In general, studies on this topic are limited because they do not compare women taking OCs with a control group of women with natural menstrual cycles who are…”
ResultPhenylephrine-induced elevations in arterial blood pressure are attenuated in heat-stressed humans
Cui, J., Wilson, T. E., & Crandall, C. G. (2002) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00195.2002 · Cited by 43 · cited 1× · see citing works
“In this context, an acute increase in diastolic or mean arterial blood pressure of 3 to 5 mm Hg is usually experimentally sufficient to abolish MSNA in healthy young subjects.(50,51) Thus, although MSNA did not differ between OC users and nonusers, it was perhaps unexpectedly high in women taking OCs given the differe…”
BackgroundCarter, J. R., Klein, J. C., & Schwartz, C. E. (2010) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00554.2009 · Cited by 40 · see citing works
Self-citationWehrwein, E. A., Joyner, M. J., Hart, E. C. J., Wallin, B. G., Karlsson, T., & Charkoudian, N. (2010) · Hypertension · doi:10.1161/hypertensionaha.109.141739 · Cited by 36 · see citing works
Self-citationInfluence of endogenous angiotensin II on control of sympathetic nerve activity in human dehydration
Rabbitts, J. A., Strom, N. A., Sawyer, J. R., Curry, T. B., Dietz, N. M., Roberts, S. K., Kingsley‐Berg, S. M., & Charkoudian, N. (2009) · The Journal of Physiology · doi:10.1113/jphysiol.2009.176693 · Cited by 35 · see citing works
Self-citationGiribela, C. R. G., de Melo, N. R., Butcher, R. D. C. G. E. S., Hong, V. C., Guerra, G. M., Baracat, E. C., & Consolim‐Colombo, F. M. (2012) · Contraception · doi:10.1016/j.contraception.2011.08.017 · Cited by 34 · cited 1× · see citing works
“In women who take these OC formulations, blood pressure does not change or may slightly decrease.(39,40) In our cohort, 6 women were taking such OCs at the time of being studied, and indeed, there was a tendency for women taking drospirenone-containing OCs to have a lower MAP than women taking other types (n=46) of OC…”
BackgroundThe effect of oral contraceptives on the nitric oxide system and renal function
Cherney, D. Z. I., Scholey, J. W., Cattran, D. C., Kang, A. K., Zimpelmann, J., Kennedy, C., Lai, V., Burns, K. D., & Miller, J. A. (2007) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.00351.2007 · Cited by 33 · cited 1× · see citing works
“Female reproductive hormones (particularly estrogens) can promote both systemic vasodilation via enhanced nitric oxide synthesis (which would lower blood pressure) and expand plasma volume (which could increase blood pressure).(44) OCs (combined estradiol and progesterone formulations) also are known to upregulate the…”
BackgroundHeidarzadeh, Z., Asadi, B., Saadatnia, M., et al. (2013) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2013.06.007 · Cited by 33 · see citing works
Curry, T. B., Somaraju, M., Hines, C. N., Groenewald, C. B., Miles, J. M., Joyner, M. J., & Charkoudian, N. (2013) · Obesity · doi:10.1002/oby.20106 · Cited by 30 · see citing works
Self-citationUsselman, C. W., Luchyshyn, T. A., Gimon, T. I., Nielson, C. A., Van Uum, S. H. M., & Shoemaker, J. K. (2013) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00681.2013 · Cited by 30 · cited 1× · see citing works
“In contrast, a recent study has suggested that MSNA is greater during the active pill phase of OC use.(10) This finding is analogous to the higher levels of MSNA seen during the luteal phase versus the follicular phase of women with natural menstrual cycles.”
ResultNIH policy: Status quo is also costly
McCullough, L. D., McCarthy, M. M., & Vries, G. J. D. (2014) · Nature · doi:10.1038/510340b · Cited by 30 · see citing works
Vestibulosympathetic reflex during the early follicular and midluteal phases of the menstrual cycle
Lawrence, J. E., Ray, C. A., & Carter, J. R. (2008) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00056.2008 · Cited by 21 · see citing works
Self-citationCagnacci, A., Zanin, R., Napolitano, A., Arangino, S., & Volpe, A. (2013) · Contraception · doi:10.1016/j.contraception.2013.04.003 · Cited by 21 · see citing works
Role of the carotid chemoreceptors in insulin-mediated sympathoexcitation in humans
Limberg, J. K., Johnson, B. D., Mozer, M. T., Holbein, W. W., Curry, T. B., Prabhakar, N. R., & Joyner, M. J. (2019) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00257.2019 · Cited by 20 · see citing works
Self-citationOral contraceptive use, iron stores and vascular endothelial function in healthy women
Friedman, J. C., Cremer, M., Jelani, Q., Huang, X., Jian, J., Shah, S. M., & Katz, S. D. (2011) · Contraception · doi:10.1016/j.contraception.2011.01.012 · Cited by 19 · see citing works
Acute sex hormone suppression reduces skeletal muscle sympathetic nerve activity
Day, D. S., Gozansky, W. S., Bell, C., & Kohrt, W. M. (2011) · Clinical Autonomic Research · doi:10.1007/s10286-011-0127-5 · Cited by 15 · cited 5× · see citing works
“Progestin-only pills have not been associated with increased blood pressure in normotensive women,42 and it is unknown whether they would be associated with changes in MSNA.”
BackgroundInfluentialPhysiology's Impact: Stop Ignoring the Obvious–SEX MATTERS!
Miller, V. M., Reckelhoff, J. F., & Sieck, G. C. (2014) · Physiology · doi:10.1152/physiol.00064.2013 · Cited by 8 · see citing works
Gender Medicine: “In a Perfect World …”
Reckelhoff, J. F. (2014) · Clinical Therapeutics · doi:10.1016/j.clinthera.2014.10.020 · Cited by 5 · see citing works
Role of the carotid chemoreceptors in insulin‐mediated sympathoexcitation in humans (873.7)
Limberg, J. K., Mozer, M. T., Joyner, M. J., et al. (2014) · The FASEB Journal · doi:10.1096/fasebj.28.1_supplement.873.7 · Cited by 4 · see citing works
Self-citationKe, H., & Burke, D. (1977) · PubMed · Cited by 4 · see citing works
Effect of the menstrual cycle on endothelium-dependent vasodilation of the brachial artery
English, J., Green, G., Jacobs, L. O., & Andrews, T. C. (1998) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)81412-5
HAGBARTH, K. E. (1976) · Sensory Functions of the Skin in Primates · doi:10.1016/b978-0-08-021208-1.50016-3
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Sex differences and blood pressure regulation in humans
Joyner, M. J., Wallin, B. G., & Charkoudian, N. (2015) · Experimental Physiology · doi:10.1113/ep085146 · Cited by 237 · see citing works
“In a follow-up analysis from our collaborative group (Harvey et al. 2015), a large number of young healthy women with normal menstrual cycles were compared with a large number who used oral contraceptives.”
BackgroundSelf-citationHart, E. C., Head, G. A., Carter, J. R., Wallin, B. G., May, C. N., Hamza, S. M., Hall, J. E., Charkoudian, N., & Osborn, J. W. (2017) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00703.2016 · Cited by 166 · see citing works
“Given that female sex hormones appear to have an effect on resting MSNA in eumenorrheic women (89) and women taking oral contraceptives (50, 90), it is suggested that women of childbearing age be studied during the same hormone phase of their menstrual cycle.”
BackgroundSelf-citationHydration Status and Cardiovascular Function
Watso, J. C., & Farquhar, W. B. (2019) · Nutrients · doi:10.3390/nu11081866 · Cited by 168 · see citing works
Autonomic control of body temperature and blood pressure: influences of female sex hormones
Charkoudian, N., Hart, E. C., Barnes, J. N., & Joyner, M. J. (2017) · Clinical Autonomic Research · doi:10.1007/s10286-017-0420-z · Cited by 156 · see citing works
“Even in this case, however, the relationship was minimal: women with MSNA that was several-fold higher had arterial pressure values that were only a few mmHg higher than those with lower MSNA [23].”
BackgroundInfluentialSelf-citationD’Souza, A. C., Wageh, M., Williams, J. S., Colenso‐Semple, L. M., McCarthy, D. G., McKay, A. K. A., Elliott-Sale, K. J., Burke, L. M., Parise, G., MacDonald, M. J., et al. (2023) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00346.2023 · Cited by 147 · see citing works
Neurovascular control of blood pressure is influenced by aging, sex, and sex hormones
Baker, S. E., Limberg, J. K., Ranadive, S. M., & Joyner, M. J. (2016) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00288.2016 · Cited by 97 · see citing works
“Despite this, oral contraceptive pill use does not appear to alter MSNA or plasma norepinephrine levels when studied during the placebo (19) or active pill (29) phases.”
BackgroundSelf-citationSympathetic regulation of blood pressure in normotension and hypertension: when sex matters
Briant, L. J. B., Charkoudian, N., & Hart, E. C. (2015) · Experimental Physiology · doi:10.1113/ep085368 · Cited by 89 · see citing works
“Numerous studies have demonstrated that MSNA was not increased in women taking oral contraceptives at rest (Harvey et al. 2015) and during various sympathoexcitatory challenges (Carter & Lawrence, 2007; Carter et al. 2010), suggesting that blood pressure may be increased owing to the influence of…”
BackgroundInfluentialSelf-citationOral Contraceptive Pills and Hypertension: A Review of Current Evidence and Recommendations
Cameron, N. A., Blyler, C. A., & Bello, N. A. (2023) · Hypertension · doi:10.1161/hypertensionaha.122.20018 · Cited by 90 · see citing works
Sex, the brain and hypertension: brain oestrogen receptors and high blood pressure risk factors
Hay, M. (2015) · Clinical Science · doi:10.1042/cs20150654 · Cited by 73 · see citing works
Barnes, J. N., & Charkoudian, N. (2020) · The FASEB Journal · doi:10.1096/fj.202001387r · Cited by 71 · see citing works
Self-citationBaker, S. E., Limberg, J. K., Dillon, G. A., Curry, T. B., Joyner, M. J., & Nicholson, W. T. (2018) · Hypertension · doi:10.1161/hypertensionaha.118.11550 · Cited by 65 · see citing works
Self-citationAge and sex differences in sympathetic and hemodynamic responses to hypoxia and cold pressor test
Miller, A. J., Cui, J. G., Luck, J. C., et al. (2019) · Physiological Reports · doi:10.14814/phy2.13988 · Cited by 58 · see citing works
Priest, S. E., Shenouda, N., & MacDonald, M. J. (2018) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00039.2018 · Cited by 56 · see citing works
Effects of different hormonal contraceptives in women's blood pressure values
Ribeiro, C. C. M., Shimo, A. K. K., Lopes, M. H. B. D. M., & Lamas, J. L. T. (2018) · Revista Brasileira de Enfermagem · doi:10.1590/0034-7167-2017-0317 · Cited by 57 · see citing works
“A correlação entre hormônios exógenos e a regulação da pressão arterial pelo sistema nervoso simpático, também foi estudada por Harvey et al.(21) e, apesar de os re-”
Sex‐specific factors regulating pressure and flow
Barnes, J. N. (2017) · Experimental Physiology · doi:10.1113/ep086531 · Cited by 52 · see citing works
“We also noted significantly higher BP values in OC women, although MSNA values were not different (Harvey et al. 2015).”
BackgroundResultSelf-citationGreater Beta-Adrenergic Receptor Mediated Vasodilation in Women Using Oral Contraceptives
Limberg, J. K., Peltonen, G. L., Johansson, R., Harrell, J. W., Kellawan, J. M., Eldridge, M. W., Sebranek, J. J., Walker, B. J., & Schrage, W. G. (2016) · Frontiers in Physiology · doi:10.3389/fphys.2016.00215 · Cited by 38 · see citing works
“…of the journal Frontiers in Physiology Received: 11 March 2016 Accepted: 23 May 2016 Published: 08 June 2016 Citation: Limberg JK, Peltonen GL, Johansson RE, Harrell JW, Kellawan JM, Eldridge MW, Sebranek JJ, Walker BJ and Schrage WG (2016) Greater Beta-Adrenergic Receptor Mediated Vasodilation in…”
BackgroundMethodInfluentialBlood pressure and muscle sympathetic nerve activity are associated with trait anxiety in humans
Bigalke, J. A., Durocher, J. J., Greenlund, I. M., Keller‐Ross, M. L., & Carter, J. R. (2023) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00026.2023 · Cited by 38 · see citing works
Self-citationBlanken, A. E., & Nation, D. A. (2020) · Journal of Alzheimer s Disease · doi:10.3233/jad-200245 · Cited by 37 · see citing works
“There are several notable factors specific to women that influence blood pressure including oral contraceptive usage, pregnancy, and menopause [132–134].”
The Specificities of Elite Female Athletes: A Multidisciplinary Approach
Castanier, C., Bougault, V., Teulier, C., Jaffré, C., Schiano-Lomoriello, S., Vibarel-Rebot, N., Villemain, A., Rieth, N., Scanff, C. L., Buisson, C., et al. (2021) · Life · doi:10.3390/life11070622 · Cited by 35 · see citing works
Gunaratne, M. D. S. K., Thorsteinsdottir, B., & Garovic, V. D. (2021) · Current Hypertension Reports · doi:10.1007/s11906-021-01147-4 · Cited by 34 · see citing works
Seeland, U., Demuth, I., Regitz‐Zagrosek, V., Steinhagen‐Thiessen, E., & König, M. (2020) · Journal of Hypertension · doi:10.1097/hjh.0000000000002386 · Cited by 32 · see citing works
“OCPs have been suspected of causing or promoting hypertension, given that several studies have shown an increase in BP associated with OCP use [16,22,28].”
ResultEffect of oral hormonal contraceptive pill use on the hemodynamic response to the cold pressor test
Jacob, D. W., Voshage, A. M., Harper, J. L., & Limberg, J. K. (2022) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00140.2022 · Cited by 28 · see citing works
Elevation of Oxidized Lipoprotein of Low Density in Users of Combined Oral Contraceptives
dos Santos, A. C. N., Petto, J., Diogo, D. P., et al. (2018) · Arquivos Brasileiros de Cardiologia · doi:10.5935/abc.20180194 · Cited by 27 · see citing works
Oral contraceptives modulate the muscle metaboreflex in healthy young women
Parmar, H. R., Sears, J., Molgat‐Seon, Y., McCulloch, C. L., McCracken, L., Brown, C. V., Sheel, A. W., & Dominelli, P. B. (2017) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2017-0482 · Cited by 25 · see citing works
Usselman, C. W., Adler, T. E., Coovadia, Y., Leone, C. A., Paidas, M. J., & Stachenfeld, N. S. (2020) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00578.2019 · Cited by 23 · see citing works
Coovadia, Y., Adler, T. E., Martin-Arrowsmith, P. W., & Usselman, C. W. (2022) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00223.2021 · Cited by 21 · see citing works
Fabunmi, O. A., Dludla, P. V., & Nkambule, B. B. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1127104 · Cited by 21 · see citing works
Usselman, C. W., Nielson, C. A., Luchyshyn, T. A., Gimon, T. I., Coverdale, N. S., Uum, S. H. M. V., & Shoemaker, J. K. (2016) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00190.2016 · Cited by 20 · see citing works
“to control participants (1, 19, 21), suggesting an effect of HC use on blood pressure regulation.”
DeLucia, C. M., Debonis, D. R., Schwyhart, S. M., & Bailey, E. F. (2021) · Journal of Applied Physiology · doi:10.1152/japplphysiol.01015.2020 · Cited by 16 · see citing works
Sayed, K. E., Macefield, V. G., Hissen, S. L., Joyner, M. J., & Taylor, C. E. (2018) · Physiological Reports · doi:10.14814/phy2.13944 · Cited by 13 · see citing works
“Importantly, when women taking oral contraceptives are compared directly to women with natural menstrual cycles in their respective low hormone phases, there are no differences in resting MSNA (Middlekauff et al. 2012; Harvey et al. 2015).”
BackgroundSelf-citationMenopause and its effects on autonomic regulation of blood pressure: Insights and perspectives
Lee, E., & Keller‐Ross, M. L. (2025) · Autonomic Neuroscience · doi:10.1016/j.autneu.2025.103295 · Cited by 12 · see citing works
Oral hormonal contraceptives and cardiovascular risks in females
Bhullar, S. K., Rabinovich-Nikitin, I., & Kirshenbaum, L. A. (2024) · Canadian Journal of Physiology and Pharmacology · doi:10.1139/cjpp-2024-0041 · Cited by 14 · see citing works
Sympathetic and blood pressure reactivity in young adults with major depressive disorder
Darling, A. M., Young, B. E., Skow, R. J., Dominguez, C. M., Saunders, E. F. H., Fadel, P. J., & Greaney, J. L. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.06.053 · Cited by 12 · see citing works
Effect of Sex and Menstrual Cycle on Skin Sensory Nerve Contribution to Local Heating
Martin, Z. T., Shannon, C. A., Kistler, B. M., Nagelkirk, P. R., & Pozzi, A. T. D. (2019) · International journal of exercise science · doi:10.70252/zfhu7113 · Cited by 12 · see citing works
Eagan, L. E., Chesney, C. A., Mascone, S. E., et al. (2022) · Experimental Physiology · doi:10.1113/ep090151 · Cited by 12 · see citing works
“Significantly higher brachial SBP in OCP users during the PP phase, as compared to non-OCP users during the EF phase, as presented in the current study, is consistent with some (Harvey et al., 2015) but not all (Adler et al., 2018; Yu et al., 2014), of the existing literature.”
ResultSex differences in the circulatory responses to an isocapnic cold pressor test
Stone, R. M., Ainslie, P. N., Kerstens, T. P., et al. (2018) · Experimental Physiology · doi:10.1113/ep087232 · Cited by 10 · see citing works
Blood Pressure: Return of the Sympathetics?
Joyner, M. J., & Limberg, J. K. (2016) · Current Hypertension Reports · doi:10.1007/s11906-015-0616-3 · Cited by 10 · see citing works
Self-citationBaker, S. E., Limberg, J. K., Scruggs, Z. M., Curry, T. B., Nicholson, W. T., Barnes, J. N., & Joyner, M. J. (2020) · Hypertension · doi:10.1161/hypertensionaha.119.14042 · Cited by 9 · see citing works
Self-citationLobysheva, I. I., Eeckhoudt, S. V., Zotti, F. D., Rifahi, A., Pothen, L., Beauloye, C., & Balligand, J. (2017) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2017.03.039 · Cited by 10 · see citing works
Mitchell, K. M., Bradbury, K. E., Posch, A., Beidleman, B. A., Fulco, C. S., Muza, S. R., & Charkoudian, N. (2017) · Autonomic Neuroscience · doi:10.1016/j.autneu.2017.11.006 · Cited by 9 · see citing works
Self-citationHypertension artérielle et contraception
Pérol, S., Hugon‐Rodin, J., & Plu‐Bureau, G. (2019) · La Presse Médicale · doi:10.1016/j.lpm.2019.07.033 · Cited by 9 · see citing works
van Rooyen, J. M., Poglitsch, M., Mels, C. M. C., Huisman, H. W., Gafane-Matemane, L. F., Roux, S. B., Lammertyn, L., Breet, Y., Uys, L., & Schutte, A. E. (2021) · Journal of Human Hypertension · doi:10.1038/s41371-021-00569-6 · Cited by 8 · see citing works
Eagan, L. E., Chesney, C. A., Mascone, S. E., et al. (2022) · University Libraries (University of Maryland) · doi:10.13016/tmau-mass · Cited by 8 · see citing works
Miranda, K. T., Schwende, B. K., Duval, A., Streed, C. G., Delage, S. I., Chokly, K., Hodgins, V., & Usselman, C. W. (2025) · Autonomic Neuroscience · doi:10.1016/j.autneu.2025.103283 · Cited by 6 · see citing works
“…cycle phase does not appear to be influenced in cisgender premenopausal hormonal contraceptive users, though variability exists based on contraceptive type and route of administration (Blake et al., 2023; Carter et al., 2010; Harvey et al., 2015; Middlekauff et al., 2012; Minson et al., 2000b).”
Pereira, T. J., Bouakkar, J., Johnston, H., Pakosh, M. T., Drake, J. D., & Edgell, H. (2023) · Clinical Autonomic Research · doi:10.1007/s10286-023-00996-0 · Cited by 6 · see citing works
“Resting MSNA was evaluated in four studies [20, 26, 37, 38], which all found that there was no influence of OC on resting cardiovascular variables (heart rate (HR), mean arterial pressure (MAP), systolic BP (SBP), diastolic BP (DBP), cardiac output (Q), stroke volume (SV), and total peripheral…”
Badrov, M. B., Keir, D. A., Notarius, C. F., O’Donnell, E., Millar, P. J., Kimmerly, D. S., Shoemaker, J. K., & Floras, J. S. (2022) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00450.2022 · Cited by 6 · see citing works
Polycystic ovary syndrome potentiates blood pressure and vascular responses to the cold pressor test
Berbrier, D. E., Coovadia, Y., Malenda, D., & Usselman, C. W. (2024) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00697.2024 · Cited by 4 · see citing works
Lee, E., Vera, K., Asirvatham‐Jeyaraj, N., et al. (2021) · Respiratory Physiology & Neurobiology · doi:10.1016/j.resp.2021.103712 · Cited by 4 · see citing works
The influence of oral contraceptives on the exercise pressor reflex in the upper and lower body
Pereira, T. J., & Edgell, H. (2024) · Physiological Reports · doi:10.14814/phy2.16144 · Cited by 4 · see citing works
“…the effects of varying doses over the pill cycle (mono vs. bi or triphasic OC) on autonomic or respiratory function; however, Harvey and colleagues (Harvey et al., 2015) did not observe any differences be-tween mono, bi, or triphasic OC in resting MAP or muscle sympathetic nervous activity.”
BackgroundThe role of arousal in maintaining the relationship between insomnia and gastrointestinal conditions
Rameshkumar, S., Arizmendi, B. J., & Salwen‐Deremer, J. K. (2024) · Translational Gastroenterology and Hepatology · doi:10.21037/tgh-23-126 · Cited by 6 · see citing works
“Some studies have found increase in indicators of autonomic arousal with oral contraceptive treatment (57) while others have not (58).”
Practice Guideline: Contraception for Adolescents with Chronic Illness
Hall, T. N., & Rende, E. K. (2017) · Journal of Pediatric Health Care · doi:10.1016/j.pedhc.2017.02.002 · Cited by 3 · see citing works
Sex and menstrual cycle effects on cerebrovascular responses to a single foot cold pressor test
Mei, Y., Allison, E. Y., Mizzi, V., et al. (2026) · Applied Physiology Nutrition and Metabolism · doi:10.1139/apnm-2024-0552 · Cited by 2 · see citing works
Rowland, S. N., Heaney, L. M., Boit, M. D., & Bailey, S. J. (2023) · Metabolites · doi:10.3390/metabo13070876 · Cited by 2 · see citing works
“Oral contraceptive pills downregulate endogenous concentrations of 17-β-estradiol and progesterone and have previously been shown to elevate blood pressure in young women in some [19,20] but not all [35] studies.”
BackgroundBerbrier, D. E., Adler, T. E., Leone, C. A., Paidas, M. J., Stachenfeld, N. S., & Usselman, C. W. (2024) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00020.2024 · Cited by 2 · see citing works
The role of peripheral venous distension reflex in regulating hemodynamics: mini review
Hamaoka, T., Sinoway, L. I., & Cui, J. G. (2024) · Autonomic Neuroscience · doi:10.1016/j.autneu.2024.103217 · Cited by 2 · see citing works
Lundblad, L. C., Eskelin, J. J., Karlsson, T., & Elam, M. (2024) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00748.2023 · Cited by 1 · see citing works
The impact of oral contraceptive pill use on sympathetic transduction at rest in young females
D’Souza, A. W., Hissen, S. L., Manabe, K., Washio, T., Annis, M. C., Sanchez, B., Usselman, C. W., Fu, Q., & Shoemaker, J. K. (2025) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00623.2024 · Cited by 1 · see citing works
Self-citationElevated blood pressure, stroke volume, and vascular tone in young women who use oral contraception
Piersol, K. L., & Buckman, J. F. (2025) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2025.112557 · Cited by 1 · see citing works
Sympathetic nervous system control across the menstrual cycle
Mei, Y., Allison, E. Y., Stone, J. C., & Al‐Khazraji, B. K. (2026) · Autonomic Neuroscience · doi:10.1016/j.autneu.2026.103438 · Cited by 1 · see citing works
The Complex Challenge of Blood Pressure Regulation
Hart, E. C., & Charkoudian, N. (2017) · Principles of Gender-Specific Medicine · doi:10.1016/b978-0-12-803506-1.00032-2 · Cited by 1 · see citing works
Self-citationShort-Term Fasting and Autonomic Control
Gonzalez, J. E. (2021) · doi:10.37099/mtu.dc.etdr/1257 · Cited by 1 · see citing works
Heart Failure Prevention: Special Considerations for Women
Chester, R. C., Press, M. C., & Horwich, T. B. (2016) · Current Cardiovascular Risk Reports · doi:10.1007/s12170-016-0490-9
Just, T. P. (2018) · ERA: Education and Research Archive (University of Alberta) · doi:10.7939/r3jm23x23
Allen, K., Chuter, K. M., Fithon, K., Marshall, L. J., & Hauton, D. (2018) · Clinical and Experimental Pharmacology and Physiology · doi:10.1111/1440-1681.13010
Sex, Age, and Neurovascular Control
Joyner, M. J., Limberg, J. K., Ranadive, S. M., & Baker, S. E. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-813197-8.00019-1
Self-citationWatso, J. C. (2024) · Library, Museums and Press - UDSpace (University of Delaware) · doi:10.58088/9f2f-3764
Sympathetic Neural Responses to Acute Thermal Sensations
Cunningham, H. A. (2020) · doi:10.37099/mtu.dc.etdr/1042
do Sacramento, S. (2020) · Global Journal of Reproductive Medicine · doi:10.19080/gjorm.2019.07.555721
Transition period of estrogen-progestogen hormone therapy
Kuznetsova, I. V. (2019) · Medical alphabet · doi:10.33667/2078-5631-2019-3-25(400)-6-10
do Sacramento, A. (2020) · Global Journal of Reproductive Medicine · doi:10.19080/gjorm.2020.07.555721
“However, some investigations have shown that COC continued use is associated with the elevation of some cardiovascular risk markers, such as an increased insulin resistance [5] changes in the lipid profile [6] elevated blood pressure [7] and subclinical inflammation [8].”
BackgroundAsirvatham‐Jeyaraj, N., Anselmo, M. F., Chantigian, D. P., Larson, M., Lee, E. J., & Keller‐Ross, M. L. (2024) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00017.2024
Laddha, U. D., Kshirsagar, K., Kotwal, G., Jadhav, A., Patil, D., & Magar, G. B. (2025) · Biomedical & Pharmacology Journal · doi:10.13005/bpj/3232 · Cited by 1 · see citing works
“43 To reduce possible risk, physicians should undertake complete health evaluations for each patient, taking into account age, body mass index (BMI), smoking status, and pre-existing medical disorders 44 .”
Hypertension in Women Across the Life Cycle: Unique Aspects and Challenges
Bond, R. M., Purewal, V. S., Cameron, N. A., Tobb, K., Adedinsewo, D. A., Isiadinso, I., & Phillips, K. A. (2026) · Current Hypertension Reports · doi:10.1007/s11906-026-01362-x · Cited by 2 · see citing works
“Ethinyl estradiol may elevate BP through enhanced angio-tensinogen production and activation of the renin–angiotensin–aldosterone system (RAAS) [10, 19–21].”
Sympathetic neural control of blood pressure across the premenopausal lifespan
Saboune, J., Boyes, N. G., Limberg, J. K., & Usselman, C. W. (2026) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00739.2025
Özcan, C., Şafak, T., & Rişvanlı, A. (2026) · Veterinary Medicine and Science · doi:10.1002/vms3.70904 · Cited by 1 · see citing works
“It is stated that E2 may decrease BP by increasing systemic vasodilation (Harvey et al. 2015 ).”
- Authors
- Harvey, R. E., Hart, E. C., Charkoudian, N., Curry, T. B., Carter, J. R., Fu, Q., Minson, C. T., Joyner, M. J., & Barnes, J. N.
- Affiliations
- From the Department of Anesthesiology, Mayo Clinic, Rochester, MN (R.E.H., T.B.C., M.J.J., J.N.B.); School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom (E.C.H.); Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA (N.C.); Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.); Institute for Exercise and Environmental Medicine at Texas Health Presbyterian...
- Michigan Technological University (US)
- ORCID
- Venue
- HYPERTENSION
- Published
- 2015-09
- Volume
- 66
- Issue
- 3
- Pages
- 590-597
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- PMC
- PMC4537364
- OpenAlex
- W2099986378
- Semantic Scholar
- 10d962f8b7c01ebc390c71e99160f995e1a50bfb
- Cited by
- 76
- References
- 62
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 10 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 8 · 2019: 6 · 2018: 8 · 2017: 8 · 2016: 5 · 2015: 3
- FWCI
- 5.81
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Commons - Michigan Tech (Michigan Technological University) (submittedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Funders
- British Heart Foundation (FS/11/1/28400)
- National Institutes of Health (UL1TR000135)
- National Institute on Aging (AG-38067, F32AG038067)
- National Heart, Lung, and Blood Institute (HL 083947, HL 118154, K99HL118154, R01HL046493, HL-46493, R21HL098676, HL-10123, HL088689, R15HL088689, K23HL075283, HL098676, HL081671, F32HL010123, R00HL118154, R01HL081671, R01HL083947)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK 082424, K23DK082424)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- combined oral contraceptives, muscle sympathetic nerve activity, systemic hemodynamics, cardiac output, systemic vascular resistance, resting blood pressure, premenopausal women, menstrual cycle, hypertension risk, female sex hormones
- MeSH terms
- Adolescent, Adult, Blood Pressure, Contraceptives, Oral, Hormonal, Female, Hemodynamics, Humans, Menstrual Cycle, Sympathetic Nervous System, Vascular Resistance, Muscle, Skeletal, Young Adult
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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