Changes in peripheral venous tone before the onset of hypertension in women with gestational hypertension

Pickles, C. J.; Brinkman, C.R.; Stainer, K.; Cowley, Alison

doi:10.1016/s0002-9378(89)80057-2

Cited by 14 publications

(9 citation statements)

References 6 publications

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“…15 However, Weinstein et al 13 and Hunyor 14 reported no difference in venous distensibility between normotensive pregnant and hypertensive pregnant women. Pickles et al 16 reported larger venous distensibility in women with preeclampsia before they developed preeclampsia. Thus, the reported results are variable.…”

Section: Venous Distensibility During Preeclampsiamentioning

confidence: 98%

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Venous distensibility during pregnancy. Comparisons between normal pregnancy and preeclampsia.

et al. 1994

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Preeclampsia is associated with increased peripheral resistance. This study was performed to determine whether an increase of venous distensibility occurs as well in preeclampsia. We obtained venous distensibility by measuring the venous pressure-volume relation in the forearm with a water-filled plethysmograph. Twenty-one women with normal pregnancy, 12 women with severe preeclampsia, and 8 women with mild preeclampsia were studied during the third trimester and/or 6 weeks after the delivery. Ten nonpregnant normotensive women were also studied. Venous distensibility was greater (P<.01) in normal pregnant women and smaller (P<.01) in women with preeclampsia during pregnancy than postpartum. and decreased intravascular volume.9 ' 10 Changes in venous distensibility in women with preeclampsia are less well documented.The venous system may be important in control of intravascular volume and blood pressure. It has been documented that essential 11 and borderline 12 hypertension are associated with decreased venous distensibility. Decreases in venous distensibility shift the intravascular volume from the peripheral to the central circulation. Thus, it is possible that impaired venous distensibility may contribute to altered hemodynamic status in preeclampsia.Several previous investigators examined venous distensibility in women with preeclampsia. Weinstein et al 13 and Hunyor 14 reported no difference between normal pregnancy and preeclampsia. Stainer et al 15 reported decreased venous distensibility during preeclampsia. However, this study was cross-sectional, and they did not examine whether it was reversible postpartum. Pickles et al 16 reported increased venous distensibility during preeclampsia. Thus, the reported results are variable. The aim of this study was to further evaluate peripheral venous distensibility in preeclampsia during © 1994 American Heart Association, Inc.sibility correlated with the severity of preeclampsia. Venous distensibility was similar between normotensive nonpregnant women, women with nonnal pregnancy during the postpartum period, and women with preeclampsia during the postpartum period. Thus, venous distensibility increased during nonnal pregnancy. In preeclampsia, the decrease of venous distensibility occurred during pregnancy but was reversed postpartum. These results may suggest that a decrease of venous distensibility occurs during preeclampsia. These venous abnormalities may contribute to impaired control of hemodynamics in preeclampsia during pregnancy.

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Section: Venous Distensibility During Preeclampsiamentioning

confidence: 98%

“…However, this study was cross-sectional, and they did not examine whether it was reversible postpartum. Pickles et al 16 reported increased venous distensibility during preeclampsia. Thus, the reported results are variable.…”

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confidence: 98%

Venous distensibility during pregnancy. Comparisons between normal pregnancy and preeclampsia.

et al. 1994

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“…Normotensive pregnancy is associated with a progressive venodilatation. 146 There are changes in venous distensibility and capacitance, to accommodate the increased flow on the venous side, both distensibility 147 and capacitance being higher in the normal pregnant than in the non-pregnant woman. In non-pregnant women, venous capacitance is greater in the leg than in the forearm, but in pregnancy, this difference is lost, presumably because of the haemodynamic effect of the gravid uterus.…”

Section: The Cardiovascular Systemmentioning

confidence: 99%

“…144 Women with GH have significantly-raised forearm venous tone by comparison with normal pregnant women, 148 but interestingly, a prospective study showed this to be preceded by a period of increased venodilatation. 146 When the central blood volume in such women was increased by a period of passive leg elevation, the women with GH showed venodilatation, unlike normal pregnant women or non-pregnant women, who showed no change. 148 Furthermore, forearm blood flow in women with GH or PE was either unchanged 144 or somewhat increased.…”

Section: The Cardiovascular Systemmentioning

confidence: 99%

Hypertension in pregnancy

Pipkin

Roberts

2000

J Hum Hypertens

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Hypertension arising during pregnancy remains one of the two most frequently-cited causes of maternal death in the UK. In some cases, pregnancy is unmasking underlying hypertension, which manifests itself in later life. Pregnant women who develop de novo proteinuric hypertension (pre-eclampsia, PE) can share many risk factors with patients with the metabolic syndrome, such as obesity, dyslipidaemia and insulin resistance. However, more than half the women who develop PE remain normotensive thereafter. There is a genetic component(s) to the disease, but it is most improbable that there is a 'PE gene'. Rather, there are factors such as geneticallydetermined thrombophilias which are predisposers but not prerequisites. Impaired placentation is a feature, with inadequate invasion of the spiral arteries by syncytiotrophoblast and poor remodelling. However, similiar features are found in association with non-hypertensive

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“…The possibility should be considered that an increase in venous return also plays a major role. In the literature, numerous data indicate a significant increase in venous capacitance (11,17,18,28,35,47). However, significant discrepancies have also been reported, depending mainly on the site of measurement of venous variables (40, 46).…”

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confidence: 99%

Venous and arterial behavior during normal pregnancy

Edouard

Pannier

London

et al. 1998

American Journal of Physiology-Heart and Circulatory Physiology

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Physiol. 43): H1605-H1612, 1998.-To assess the contribution of the arterial and venous systems in the hemodynamic changes of normal pregnancy, we studied blood flow, vascular resistance, venous tone, and the viscoelastic properties (''creep'') of the upper and lower limbs (using plethysmography), aortic distensibility (using pulse wave velocity measurements), and cardiac dimensions (using echocardiography) in nine healthy women. Studies were longitudinally performed at the first (10-13 wk) and third (33-38 wk) trimesters of pregnancy in comparison with the period between the third and sixth month after delivery. From the first trimester, heart rate significantly increased while systemic blood pressure and limb vascular resistances did not change significantly and aortic distensibility increased (P Ͻ 0.05). Lower limb viscoelastic properties decreased at the third trimester (P Ͻ 0.05) and venous tone increased from the first trimester (P Ͻ 0.01), whereas little changes were observed at the site of upper limbs. The decrease in calf venous tone was significantly correlated with the increase in left ventricular diastolic diameter at the first (P Ͻ 0.001) and the third trimester (P Ͻ 0.05). The study provides evidence that during normal pregnancy, changes in the arterial and venous sides of the circulation occur independently of pressure alterations. The increase in venous tone, contributing to preload augmentation, and the decrease in aortic stiffness, reducing afterload, both optimize cardiac function until delivery. venous tone; aortic compliance; arterial distensibility; cardiac function IT IS WELL ACCEPTED that a normal pregnancy is characterized by a large increase in total blood volume and in cardiac output (31,32,48). Blood volume expansion appears early during the pregnancy and rises up to 50%. Cardiac output rises up to 40-50% above nonpregnant values, and the highest increase is reached halfway through gestation. Cardiac output is the product of heart rate and stroke volume. Heart rate is known to reach a 10-27% increase between weeks 4 and 36 of pregnancy (10). However, an increase in stroke volume might also play an important role at the early phase. Stroke volume appears elevated at least until weeks 28-32 (31). The mechanism(s) causing the increase in stroke volume are not yet well established. In pregnant rats and women, an increased cardiac contractility has been suggested (13,36,44), but the differentiation between the contractile properties of cardiac muscle itself and the contractile changes that result from altered preload and afterload is difficult to establish. The possibility should be considered that an increase in venous return also plays a major role. In the literature, numerous data indicate a significant increase in venous capacitance (11,17,18,28,35,47). However, significant discrepancies have also been reported, depending mainly on the site of measurement of venous variables (40, 46). Furthermore, the early venous changes could not be adequately detected because pregnant women were not ...

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Changes in peripheral venous tone before the onset of hypertension in women with gestational hypertension

Cited by 14 publications

References 6 publications

Venous distensibility during pregnancy. Comparisons between normal pregnancy and preeclampsia.

Venous distensibility during pregnancy. Comparisons between normal pregnancy and preeclampsia.

Hypertension in pregnancy

Venous and arterial behavior during normal pregnancy

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