Renin-angiotensin-aldosterone, sympathetic and endothelin systems in normal and hypertensive pregnancy

Polónia, Jorge; Ferreira-de-Almeida, J; Matias, Alexs A.; Campelo, Marcio Wilker Soares; Branco, Altina Castelo; Patrı́cio, Belmiro; Osswald, Walter

doi:10.1097/00004872-199312050-00100

Cited by 8 publications

(5 citation statements)

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“…Our finding of increased levels of norepinephrine in pre-eclampsia are supportive of the observation of Polonia et al 16 These authors reported increased plasma norepinephrine levels in nine women with pregnancy-induced hypertension compared to eight normotensive pregnant women. In contrast to the present study, however, there was no accentuation of this difference between groups with upright posture.…”

Section: Discussionsupporting

confidence: 92%

“…For example, the subjects in the report of Polonia were supine (rather than in the left lateral postion) prior to the standing phase, they were upright for fifteen (rather than ten) minutes, and dietary sodium intake was not assessed or measured. 16 A majority of studies have reported decreased activity of the renin-angiotensin system in preeclampsia, 17 although there have been contrary reports. We observed PRA to be higher in both pregnant groups compared with the nonpregnant subjects, as expected.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to the present study, however, there was no accentuation of this difference between groups with upright posture. 16 It is probable that differences in study protocols account for these discrepant responses to upright posture. For example, the subjects in the report of Polonia were supine (rather than in the left lateral postion) prior to the standing phase, they were upright for fifteen (rather than ten) minutes, and dietary sodium intake was not assessed or measured.…”

Section: Discussionmentioning

confidence: 99%

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Effect of changes in body posture on vasoactive hormones in pre-eclamptic women

et al. 2004

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The aim of this study was to determine the normality or otherwise of neurohormone indices, particularly the sympathetic nervous system, in pre-eclamptic patients and document whether changes in body posture magnify any differences between pre-eclamptic and normal women. We studied 11 women with pre-eclampsia and compared them with 17 matched normotensive pregnant women and eight nonpregnant women. Measurements of arterial pressure, heart rate and neurohormones were carried out with subjects in the left lateral position, then supine, left lateral, with upright posture and finally with assumption of the left lateral position again. Main outcome measures were arterial pressure, heart rate and hormones (plasma norepinephrine, renin activity, natriuretic peptides and endothelin-1). We observed that plasma norepinephrine levels were higher in pre-eclamptic than normotensive pregnant women and this was most obvious in the upright position. Plasma renin activity was likewise higher in pre-eclamptic than normotensive pregnant women, again most obvious with upright posture. Plasma natriuretic peptides and endothelin-1 levels were similar in pre-eclamptics and normotensive pregnant women. These data strengthen the premise that pre-eclampsia is associated with sympathetic overactivity as reflected by plasma norepinephrine levels, most obviously observed in the upright position.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of changes in body posture on vasoactive hormones in pre-eclamptic women

et al. 2004

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“…Another factor that may contribute to pre‐eclamptic vasospasm is the increased levels of circulating vasopressor substances. Previous studies 28,29 including ours 30 have consistently found that, as opposed to normotensive pregnancy, pre‐eclampsia is characterised by increased peripheral vascular resistances and plasma volume contraction along with an increase of sympathetic system activity and of endothelin plasma levels. In the present study a two‐fold increase of noradrenaline and of its deaminated metabolite DOPEG levels, and a three fold increase of endothelin levels, were found in the plasma of pre‐eclamptic women as compared with normotensive controls.…”

Section: Discussionmentioning

confidence: 62%

Association of circulating endothelin and noradrenaline with increased calcium‐channel binding sites in the placental bed in pre‐eclampsia

Ferreira-de-Almeida¹,

Amenta

Cardoso³

et al. 1998

BJOG

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Objective To evaluate factors contributing to both placental hypoperfusion and maternal Design Single centre, comparative study of calcium-channel density and affinity in the placental bed Setting Teaching hospital.Participants Twenty-two primigravidae in the third trimester of pregnancy: 10 with pre-eclampsia and 12 normotensive.Methods Plasma levels of endothelin-1 (by RIA) and noradrenaline (by HPLC-ED) were measured. Both pharmacological characterisation and anatomical localisation of dihydropyridinesensitive binding sites (using radioligand-binding studies and autorradiographic techniques) were determined with 3H-isradipine in placental bed tissues to determine both the density (Bmax) and the affinity (Kd) of receptor sites. Results Higher plasma levels of endothelin-1 and noradrenalin were found in women with preeclampsia compared with normotensive women. Placental bed tissues bound 3H-isradipine in a saturable, reversible time and temperature-dependent manner with very low Kd values. Study of the 3H-isradipine specificity binding included the use of several dihydropyridine displacers. In the group with pre-eclampsia the Scatchard analysis of the results showed a significant increase ( P < . Autoradiography confirmed that in the placental bed tissue of those with pre-eclampsia there was a much higher silver grain density in the arteries walls, compared with norrnotensive women.0 ConclusionsIn pre-eclampsia there is an increase in the maternal circulation of two strong vasoconstrictor factors (endothelin-1 and noradrenalin) and a sharp increase both in the density and the affinity of calcium-channel binding sites in placental bed central area. The latter may strongly contribute to the perpetuation of the uteroplacental hypoperfusion either by itself or by amplifying the local actions of circulating factors, such as endothelin-1 and noradrenalin.vasoconstriction in pre-eclampsia.of pregnant women with normotension and pre-eclampsia.

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“…Pregnancy and pre-eclampsia are unique conditions that cannot be compared with non-pregnant subjects because the two conditions seem to bestow a heightened sensitivity to mediators. However, it seems that renin–angiotensin [ 14 ] and catecholamines might contribute to the conditions in humans [ 21 , 22 ] and in animals [ 23 ].…”

Section: Reviewmentioning

confidence: 99%

Hypertensive emergencies: a new clinical approach

Lagi

Cencetti

2015

Clin Hypertens

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The expression ‘hypertensive urgencies’ includes many diseases. The unifying features of these diseases are a high level of arterial pressure and acute distress of one or more organs. The aim of the review was to define the idea of the ‘acute hypertension’ as a new concept, different from ‘chronic hypertension’. Acute hypertension might be related to ‘organ damage’ because it is the cause, the consequence or an effect of the acute stress. We compounded a narrative review which has included analyses of 373 articles. The structure of the search strategy included a literature search of PubMed, MEDLINE, Cochrane Library and Google Scholar databases. We applied the following inclusion criteria: prospective double-blind randomised controlled trials, experimental animal work studies, case–control studies and recruiting patients representative of the general sick population. In this review, the diseases included in the term ‘hypertensive emergencies’ share ‘acute’ hypertension. This is a new idea that emphasises the suddenly increased arterial pressure, irrespective of the initial arterial pressure and independent of the goals of hypertension control. The ‘hypertensive emergencies’ have been grouped together in three subsets: (1) diseases that result from acute hypertension that is caused by faulty regulation of the peripheral circulation (acute primary hypertension), (2) diseases that produce hypertension (acute secondary hypertension) and 3) diseases that have hypertension as an effect of the acute stress caused by the principle disease (acute associated hypertension). This review highlights a novel idea: acute hypertension is a common sign of different diseases characterised by the sudden surge of arterial pressure, so overwhelming the difference between hypertensive emergencies and urgencies. The judgment of acute hypertension is independent of the initial arterial pressure, normotension or hypertension and is linked with the transient failure of the baroreflex. Hypertensive emergencies are grouped together because all of these diseases require prompt therapy to prevent the negative outcomes of acute hypertension

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Renin-angiotensin-aldosterone, sympathetic and endothelin systems in normal and hypertensive pregnancy

Cited by 8 publications

References 0 publications

Effect of changes in body posture on vasoactive hormones in pre-eclamptic women

Effect of changes in body posture on vasoactive hormones in pre-eclamptic women

Association of circulating endothelin and noradrenaline with increased calcium‐channel binding sites in the placental bed in pre‐eclampsia

Hypertensive emergencies: a new clinical approach

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