What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Healthy volunteers (n=42). Intervention: Female sex vs. Male sex. Primary outcome: Plasma concentration of ANG-(1-7) (fmol/ml) (p=0.04).

February 7, 2015Open Access

Differences in angiotensin (1–7) between men and women

JSJennifer C. SullivanAugusta University PRPaula Rodriguez‐MiguelezVirginia Commonwealth University MZMargaret A. ZimmermanTulane University

Key Result

Healthy women exhibited significantly higher plasma concentrations of ANG-(1-7) compared with men (49.5 vs 35.9 fmol/ml, P=0.04).

Study Design

Type

Cross-Sectional (n=42)

Multicenter

Structured PICO

Are there sex differences in circulating concentrations of angiotensin (1-7) in healthy humans?

Population

42 apparently healthy volunteers (21 men and 21 women; age range, 19-48 yr)

Intervention

Female sex

Comparator

Male sex

Outcome

Plasma concentrations of ANG-(1-7) and ANG IIsurrogate

Healthy women exhibit significantly higher plasma concentrations of ANG-(1-7) compared with men, suggesting a sex-dependent relationship between ANG-(1-7), vascular function, and blood pressure.

Main Result

Absolute Event Rate: 49.5% vs 35.9%

p-value: p=0.04

Limitations

Small sample size
Lack of protease inhibitors during blood collection may have affected ANG-(1-7) stability differently between sexes
Cross-sectional design cannot infer causation between ANG-(1-7) and vascular function

Abstract

UNLABELLED: In experimental animal models of hypertension, angiotensin (1-7) ANG-(1-7) is higher in females compared with males; however, it is less clear whether the same applies to humans. Therefore, this study sought to compare circulating concentrations of ANG-(1-7) in apparently healthy men and women under normal physiological conditions. With the use of a cross-sectional experimental design, blood was collected in EDTA anticoagulant from 42 volunteers (21 men and 21 women; and age range, 19-48 yr) for analysis of plasma concentrations of ANG-(1-7) and ANG II. Blood pressure was measured and vascular endothelial function was determined (n = 25) using the brachial artery flow-mediated dilation (FMD) test. As a result, women exhibited a higher circulating concentration of ANG-(1-7) (P = 0.04) compared with men, whereas values of ANG II were similar between groups. Baseline arterial diameter, peak diameter, and shear rate were significantly greater (P < 0.02) in men compared with women. No significant differences in FMD, FMD normalized for shear, or time to peak dilation were observed between men and women. In addition, a positive correlation between ANG-(1-7) and FMD (P = 0.04) and negative association between ANG-(1-7) with ANG II (P = 0.01) were only identified in men, whereas a positive relationship between ANG-(1-7) and diastolic blood pressure (P = 0.03) was observed in women. IN CONCLUSION: , women exhibit significantly higher plasma concentrations of ANG-(1-7) compared with men. In addition, this study describes a relationship between ANG-(1-7), vascular function, and diastolic blood pressure that appears to be sex dependent.

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