Antenatal Programming of Blood Pressure

South, Andrew M.

doi:10.1007/978-3-319-31420-4_57-1

Cited by 1 publication

(6 citation statements)

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Section: Evidence For Raas-mediated Antenatal Programmingmentioning

confidence: 99%

“…35 This abnormal placental development may contribute to underexpression or overexpression of placental RAAS components and excess shedding of placental particles such as miRNA that target RAAS mRNA. 36 Subsequent release of RAAS components into the maternal circulation from the fetal-placental unit (eg, increased Ang II, decreased Ang- [1][2][3][4][5][6][7]) may alter the systemic and tissue-specific maternal RAAS, including the intrarenal RAAS, subsequently reduce uteroplacental blood flow, and further drive placental damage. 35,37 Women who develop preeclampsia demonstrate decreased glomerular filtration rate, PRA, and aldosterone before and at the time of diagnosis, consistent with a volume-expanded circulation.…”

Section: The Raas In Normal Pregnancy Physiologymentioning

confidence: 99%

“…52 However, a major paradox in the field is whether preterm birth and lower birth weight in and of themselves are necessary and sufficient to cause programming or the antecedent exposures (eg, preeclampsia) actually program future disease. 1,53 Various genetically modified animal models could be used to study the effects of antenatal RAAS manipulations on offspring outcomes. However, most studies that use genetic manipulations have targeted the offspring's genome rather than that of the parents.…”

Section: Offspring Healthmentioning

confidence: 99%

“…Briefly stated, antenatal programming happens when exposures occur from conception through birth that alter structural, physiological, and metabolic fetal development and maternal health to improve short-term survival but at the expense of programmed adverse cardiovascular health in the long term (ie, developmental plasticity). 1 For example, maternal hypertension, the most common medical comorbidity in pregnancy, is a major health concern and is associated with increased risks of short-term mortality and morbidity, as well as programmed chronic disease later in life in both the mother and the fetus. 2 Offspring of women with preeclampsia have lower birth weight and higher blood pressure throughout childhood and young adulthood compared with unexposed offspring.…”

mentioning

confidence: 99%

“…cardiovascular health in the long term (ie, developmental plasticity). 1 For example, maternal hypertension, the most common medical comorbidity in pregnancy, is a major health concern and is associated with increased risks of short-term mortality and morbidity, as well as programmed chronic disease later in life in both the mother and the fetus. 2 Offspring of women with preeclampsia have lower birth weight and higher blood pressure throughout childhood and young adulthood compared with unexposed offspring.…”

mentioning

confidence: 99%

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Appraising the Preclinical Evidence of the Role of the Renin-Angiotensin-Aldosterone System in Antenatal Programming of Maternal and Offspring Cardiovascular Health Across the Life Course: Moving the Field Forward: A Scientific Statement From the American Heart Association

Alexander¹,

South²,

August³

et al. 2023

Hypertension

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There is increasing interest in the long-term cardiovascular health of women with complicated pregnancies and their affected offspring. Emerging antenatal risk factors such as preeclampsia appear to increase the risk of hypertension and cardiovascular disease across the life course in both the offspring and women after pregnancy. However, the antenatal programming mechanisms responsible are complex and incompletely understood, with roots in alterations in the development, structure, and function of the kidney, heart, vasculature, and brain. The renin-angiotensin-aldosterone system is a major regulator of maternal-fetal health through the placental interface, as well as kidney and cardiovascular tissue development and function. Renin-angiotensin-aldosterone system dysregulation plays a critical role in the development of pregnancy complications such as preeclampsia and programming of long-term adverse cardiovascular health in both the mother and the offspring. An improved understanding of antenatal renin-angiotensin-aldosterone system programming is crucial to identify at-risk individuals and to facilitate development of novel therapies to prevent and treat disease across the life course. Given the inherent complexities of the renin-angiotensin-aldosterone system, it is imperative that preclinical and translational research studies adhere to best practices to accurately and rigorously measure components of the renin-angiotensin-aldosterone system. This comprehensive synthesis of preclinical and translational scientific evidence of the mechanistic role of the renin-angiotensin-aldosterone system in antenatal programming of hypertension and cardiovascular disease will help (1) to ensure that future research uses best research practices, (2) to identify pressing needs, and (3) to guide future investigations to maximize potential outcomes. This will facilitate more rapid and efficient translation to clinical care and improve health outcomes.

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Section: Evidence For Raas-mediated Antenatal Programmingmentioning

confidence: 99%