Blood pressure, the renin-aldosterone system and sex steroids throughout normal pregnancy

Wilson, M. G. A.; Morganti, Alberto; Zervoudakis, Ioannis A.; Letcher, R. L.; Romney, Benjamin; Oeyon, P. Von; Papera, S.; Sealey, Jean E.; Laragh, John H.

doi:10.1016/0002-9343(80)90178-3

Cited by 317 publications

(135 citation statements)

References 42 publications

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“…10 Results are in accordance with studies done by various authors. [10][11][12][13][14] In present study, systolic blood pressure was slightly less in all the trimesters as compared to control group which was statistically not significant. There was gradual increase in SBP from I to III trimesters.…”

Section: Discussionsupporting

confidence: 92%

Role of echocardiography for assessment of cardiovascular haemodynamics during pregnancy

Somani¹,

Sunandini

Somani³

2016

Int J Reprod Contracept Obstet Gynecol

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Background: Pregnancy is associated with volume overload producing significant vascular and hemodynamic adaptations in cardiovascular physiology. Present study was designed to follow up gradual adaptations in cardiovascular hemodynamics during the course of pregnancy using Doppler echocardiography which is reproducible and noninvasive technique. Methods: In present prospective study of 50 women, were divided into 2 groups of 25 each: control group & study group (pregnant patient in I trimester, II trimester & III trimester). They were non-invasively analysed for cardiovascular function and systemic hemodynamics using echocardiography and compared with control group. The data was analysed using ANOVA for comparison within the group and student's t-test for comparison between the groups. p value <0.05 was considered to be significant. Results: Mean age and height in control and study groups were comparable. Weight gain was within the expected range with advancement of pregnancy. Heart rate was increased in I and II trimesters with peak rise in III trimester. The difference between control group and study groups was statistically significant (p < 0.05).Systolic blood pressure was slightly decreased in all the trimesters as compared to control group which was statistically not significant. There was gradual increase in SBP from I to III trimesters. Diastolic blood pressure progressively decreased in I and II trimesters and then increased in III trimester. The difference in DBP between control group and I, II trimesters of pregnancy was significant (p<0.05).Systemic vascular resistance progressively decreased with advancement of pregnancy and difference was statistically significant (p <0.05) . Cardiac output is steadily increased in all trimesters of pregnancy with peak at 36 weeks and was statistically significant (p<0.05). It was due to increase in both heart rate and Stroke volume. Ejection fraction also increased in all trimesters. Conclusions: Present study shows significant functional changes in the cardiovascular dynamics during pregnancy. Doppler echocardiography provides an excellent noninvasive method for the evaluation and serial analysis of hemodynamic changes. These results will help in distinguishing abnormal echocardiographic changes from the normal physiologic changes of pregnancy. Therefore maternal echocardiography should be introduced into the antenatal management protocol, which will help to identify women at high risk to developing cardiovascular complications and there by early intervention.

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Section: Discussionsupporting

confidence: 92%

Role of echocardiography for assessment of cardiovascular haemodynamics during pregnancy

Somani¹,

Sunandini

Somani³

2016

Int J Reprod Contracept Obstet Gynecol

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“…We intercontraceptive therapy, which increases angiotensinogen synthesis. [29][30][31][32][33] PRA increases in parallel with pret this finding by two factors: firstly a bias caused by the exclusion (for ethical reasons) of patients who plasma estradiol levels during pregnancy. 34 There were no significant changes observed in the insulin sustained a marked rise in BP after 2 weeks of discontinuing antihypertensive treatment, and secvalues or change in insulin levels between the PL and the two HRT groups.…”

Section: Discussionmentioning

confidence: 99%

The effect of hormone replacement therapy on blood pressure and cardiovascular risk factors in menopausal women with moderate hypertension

Kornhauser¹,

Jm²,

Garay³

et al. 1997

J Hum Hypertens

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Objective: To assess the effect of injectable hormone PL group but did not change in the E and E+P patients.No change was observed in the serum levels of total replacement therapy (HRT) vs a placebo in hypertensive menopausal women. cholesterol or low density lipoprotein (LDL)-cholesterol at the end of the trial. Plasma renin activity (PRA), aldosDesign and methods: Prospective randomised doubleblind study over 90 days. Fifty-five menopausal women terone and insulin levels decreased during the study; PRA fell more significantly in the E+P group, the aldoswith mild to moderate hypertension, stopped their antihypertensive medication and were studied for 2 weeks.terone reduction was highly significant in both hormone treated groups, specially the E+P group. Plasma insulin Diastolic BP increased to over 105 mm Hg in five patients who were not included in the study. The decreased in all groups and FSH levels were lower in the two treatment groups. remaining patients were randomly allocated to three groups: placebo (PL), estradiol valeranate 10 mg (E), Conclusions: In a randomised controlled trial no rise in BP was found after 90 days in hypertensive women with and estradiol valeranate 4 mg plus prasterone enantate 200 mg (E+P). A further five patients were excluded from two forms of HRT. There was an unexpected fall in BP in those women allocated to placebo injections. the study for different reasons. Results: Standing and recumbent BP decreased in the Keywords: hormone replacement therapy; menopause; high blood pressure systemic BP. Oestrogen administration increases Introduction plasma renin activity (PRA), plasma aldosterone, During the menopause, low plasma oestrogen levels and causes sodium retention. These factors increase are associated with an increased risk of cardiovascuboth extracellular volume and cardiac output. 9 Furlar disease. [1][2][3][4] Hormone replacement therapy (HRT) thermore, oestrogen treatment induces vasomay modify this risk factor, although this effect is dilation. 10 Hypertensive patients may also have still a matter of debate. 5 It is possible that ethnic and insulin resistance, with increased plasma glucose environmental factors including lifestyle may interand insulin levels. 11,12 act to explain variation in risk for hypertension inThe interaction of hypertension with these other menopausal women from differing populations. We risk factors must be considered for the assessment have recently reported that in our population the of HRT in menopausal women, including overfrequency of hypertension and obesity increased at weight and blood lipid levels. 13 Plasma fibrinogen the time of menopause. 6 This phenomenon seems to has also been proposed as an independent risk factor vary in different ethnic roups, as the Framingham for cardiovascular disease. 14 In this study we report study did not report changes in blood pressure (BP), the results of a randomised double-blind trial, exambody weight or blood glucose. 7 By contrast, ining the effects of injectable HRT in menopausal increased rates...

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“…In addition, aldosterone concentrations increase and cause an increase in blood volume resulting in high sodium absorption and water retention, a response in opposition with the described effect of high intake of salt (see above). Similarly, despite the increase in plasma volume, blood pressure falls during normal pregnancy (Wilson et al, 1980); another physiological response oppose to that induced by high intake of salt. These physiological 'conflicts' result in the specific activation of the RAS in response to highsalt intake during pregnancy.…”

Section: Digby Chadwick and Blachementioning

confidence: 99%

Salt intake and reproductive function in sheep

Digby

Chadwick

Blache

2011

Animal

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Producers have the possibility to combat human-induced dryland salinity by planting salt-tolerant plants such as saltbush. Saltbush has the potential to be used as a source of food for livestock at a time and place where pasture is not viable. However, saltbush contains high concentrations of sodium chloride salt and some other anti-nutritional factors that have the potential to affect feed and water intake and, directly or indirectly, the reproductive capacity of sheep. High-salt diet during gestation induces a small modification of the activity of the renin-angiotensin system (RAS) that has an important role in the maintenance of the salt-water balance in non-pregnant and pregnant sheep. In contrast, the main effect of salt ingestion during pregnancy is observed on the biology of the offspring, with changes in the response of the RAS to salt ingestion and altered thirst threshold in response to an oral salt ingestion. These changes, observed later in life, are the result of fetal programming following the ingestion of salt by the mother. It seems that the exposure to salt during pregnancy could provide an advantage to the offspring because of this adaptive response. The response may be particularly useful, for example, when grazing herbivores are fed halophytic forages adapted to saline soils.

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Blood pressure, the renin-aldosterone system and sex steroids throughout normal pregnancy

Cited by 317 publications

References 42 publications

Role of echocardiography for assessment of cardiovascular haemodynamics during pregnancy

Role of echocardiography for assessment of cardiovascular haemodynamics during pregnancy

The effect of hormone replacement therapy on blood pressure and cardiovascular risk factors in menopausal women with moderate hypertension

Salt intake and reproductive function in sheep

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