Tohoku J. Exp. Med., 2021 January, 253(1)

Vascular Endothelial Dysfunction and Autonomic Nervous Hyperactivity among Premenopausal Women with Cold-Sensitivity Constitution (Hiesho)

Kaori Kono,^1,2 Shichiro Abe,¹ Machiko Yamamoto,³ Ryo Kayashima,² Kentaro Kaneko,³ Masashi Sakuma,¹ Shigeru Toyoda,¹ Toshiaki Nakajima¹ and Teruo Inoue¹

¹Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Shimotsuga-gun, Tochigi, Japan
²Department of Fundamental Nursing, Dokkyo Medical University School of Nursing, Shimotsuga-gun, Tochigi, Japan
³Ibaraki Christian University Graduate School of Nursing, Hitachi, Ibaraki, Japan

The cold-sensitivity constitution (CSC), termed �gHiesho�h in Japanese, is a woman-specific cold sense of peripheral sites. The etiology of and criteria for CSC are not yet well established. We defined CSC as temperature gradient > 6C between body surface and core, and investigated the autonomic nervous activity by measuring heart rate variability and the vascular endothelial function by determining reactive hyperemia index (RHI) in 43 healthy premenopausal women, aged 18-47 years. Twenty five women had CSC during both the follicular and luteal phases of their menstrual cycles (sustained-CSC group), 8 women did not show CSC during both phases (non-CSC group), and the remaining 10 women showed CSC in either menstrual phase (occasional CSC). To identify the pathophysiological bases of CSC, we compared the sympathetic nervous activity and vascular endothelial function between sustained-CSC and non-CSC. We thus found that sympathetic nervous activity was higher among the sustained-CSC group (p = 0.042) during the follicular phase, compared with the non-CSC group, while the RHI was similar in both groups. Furthermore, the sympathetic nervous activity was similar between the sustained-CSC women aged 40 years (n = 10) and those aged < 40 years (n = 15) during either menstrual phase, whereas the RHI of the women aged < 40 years was lower during the follicular phase (p = 0.045), compared with the women aged 40 years. In conclusion, CSC is associated with sympathetic nervous hyperactivity in premenopausal women, and vascular endothelial dysfunction is also involved in CSC among younger women.

Keywords —— autonomic nervous activity; cold-sensitivity constitution; heart rate variability; reactive hyperemia-peripheral arterial tonometry; vascular endothelial function

© 2021 Tohoku University Medical Press

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Tohoku J. Exp. Med 2021 253, 51-60.

Correspondence: Shichiro Abe, M.D., Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi 321-0293, Japan.

e-mail: abenana@dokkyomed.ac.jp