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Race and sex differences in cardiovascular autonomic regulation

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Abstract

Racial and ethnic differences in cardiovascular morbidity and mortality persist despite advances in risk factor identification and implementation of evidence-based treatment strategies. African American men and women are disproportionately affected by cardiovascular risk factors, particularly hypertension. In this context, previous studies have identified sex and racial differences in autonomic cardiovascular regulation which may contribute to the development of hypertension and its high morbidity burden among African Americans. In this review, we provide a comprehensive evaluation of the potential pathophysiological mechanisms of blood pressure control and their differences based on sex and race. These mechanisms include obesity-induced sympathetic activation, sympatho-vascular transduction, baroreflex sensitivity and adrenoreceptor vascular sensitivity, which have been the subjects of prior investigation in this field. Understanding the racial differences in the pathophysiology of hypertension and its co-morbid conditions would allow us to implement better treatment strategies tailored to African Americans, with the ultimate goal of reducing cardiovascular mortality in this population.

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Acknowledgements

The authors have no acknowledgements.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Drexel University College of Medicine, Philadelphia, PA, USA

    Maureen C. Farrell & Richard J. Giza

  2. Department of Medicine, Division of Clinical Pharmacology, Vanderbilt Autonomic Dysfunction Center, Vanderbilt University Medical Center, 506 Robinson Research Building, Nashville, TN, 37232-6602, USA

    Cyndya A. Shibao

Authors
  1. Maureen C. Farrell
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  2. Richard J. Giza
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  3. Cyndya A. Shibao
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Corresponding author

Correspondence to Cyndya A. Shibao.

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Conflict of interest

MCF and RJG have no competing interests to declare. CAS received grant support from the Food and Drug Administration Office of Orphan Products Development, Grant #FD-R-04778-01-A3. CAS has received speaker honoraria from Lundbeck Pharmaceuticals. CAS received consulting honoraria from Lundbeck and Theravance Biopharma. CAS is a member of the Board of the American Autonomic Society.

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Farrell, M.C., Giza, R.J. & Shibao, C.A. Race and sex differences in cardiovascular autonomic regulation. Clin Auton Res 30, 371–379 (2020). https://doi.org/10.1007/s10286-020-00723-z

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