Uterine fibroids and risk of hypertension: Implication of inflammation and a possible role of the renin‐angiotensin‐aldosterone system

Armanini, Decio; Sabbadin, Chiara; Donà, Gabriella; Bordin, Luciana; Marin, Loris; Andrisani, Alessandra; Ambrosini, Guido

doi:10.1111/jch.13262

Cited by 12 publications

(12 citation statements)

References 21 publications

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“…В подтверждение этого в исследованиях зарубежных коллег выявлена индуцированная АТ II пролиферация клеток лейомиомы [11]. Хорошо известна и значительная роль АТ II в патогенезе АГ как фактора, непосредственно индуцирующего вазоконстрикцию и косвенно стимулирующего синтез альдостерона [6].…”

Section: Discussionunclassified

“…Хорошо известна и значительная роль АТ II в патогенезе АГ как фактора, непосредственно индуцирующего вазоконстрикцию и косвенно стимулирующего синтез альдостерона [6]. Кроме того, в некоторых исследованиях обнаружена значительная ассоциация между полиморфизмом участка А1166С в гене рецептора АТ II типа 1 (АGТR1) и лейомиомой [11].…”

Section: Discussionunclassified

“…Ингибирование АПФ, а также блокада АGТR1 подавляют ангиогенез и рост опухоли, уменьшают митотический индекс и пролиферацию клеток [10,11]. Поэтому не исключено, что ингибиторы АПФ и антагонисты рецепторов АТ могут использоваться для предотвращения или уменьшения развития опухоли у восприимчивых субъектов, несущих эти генетические полиморфизмы [11].…”

Section: Discussionunclassified

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Between Uterine Fibroid and High Cardiovascular Risk in Premenopausal Women

Болотова¹,

Дудникова²,

Крутова³

et al. 2021

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Study Objective: To assess the association between major factors of cardiovascular risk and uterine fibroid in premenopausal women. Study Design: full prospective study. Materials and Methods. The study included 296 patients (mean age: 44.76 (5.65) years old). Patients were divided into two groups: study group — 160 women with confirmed uterine fibroid, and controls — 136 women without uterine fibroid, of similar age (44.36 (6.78) and 45.17 (5.23) years, respectively). Study Results. As compared to controls, women with fibroid had statistically higher rate of arterial hypertension (AH) (33.1% vs 10.3%, respectively, χ2 = 21.8, p = 0.001), metabolic disorders (7.5% vs 2.2%, χ2 = 4.283, р = 0.03), hypercholesterolemia (37.5% vs 18.3%, χ2 = 18.524, р = 0.001), overweight (35% vs 23.5%; χ2 = 4,.63, p = 0.03), and mean waist/ hip circumference ratio (р = 0.02). Regression analysis demonstrated independent positive correlations between uterine fibroid and AH (OR = 2.02; 95% CI: 1.25–3.27, р = 0.004), hypercholesterolemia (OR = 2.51; 95% CI: 1.82–3.79, р = 0.001), abdominal obesity (OR = 2.98; 95% CI: 1.95–4.19; р = 0.004), metabolic disorders (OR = 2.43; 95% CI: 1.23–4.79; р = 0.01). There were no statistically significant differences in the rate of smoking, anaemia, body mass index, main reproductive parameters between groups. Conclusion. Available information shows that the cardiovascular risk profile in premenopausal women is worse than in controls. A comprehensive study of metabolic and cardiovascular risk profiles and their association with uterine fibroid is required; it will allow mitigating the cardiovascular risk in this group of women by the time they enter the menopause. Keywords: cardiovascular risk factors, uterine fibroid

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Section: Discussionunclassified

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Between Uterine Fibroid and High Cardiovascular Risk in Premenopausal Women

Болотова¹,

Дудникова²,

Крутова³

et al. 2021

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“…These studies are consistent with possible extra-uterine mechanisms involved in hypertension in UF. It is unlikely an involvement of progesterone because of its MR antagonism, while Aldo could be the pathogenetic factor common to hypertension and UF and could explain the association of UF with other Aldo-related disorders, such as insulin resistance, obesity and PCOS (58).…”

Section: Aldosterone and Uterine Fibroidsmentioning

confidence: 99%

Aldosterone in Gynecology and Its Involvement on the Risk of Hypertension in Pregnancy

et al. 2019

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Aldosterone is the main mineralocorticoid hormone, responsible of the regulation of fluid and electrolyte balance and blood pressure. It acts also as a pro-inflammatory factor responsible of an increased cardiovascular risk, independent from blood pressure values. After the discovery of mineralocorticoid receptor (MR) in mononuclear leukocytes, further studies supported its role in inflammatory and even autoimmune mechanisms underlying several diseases. In particular, recent studies reported a possible involvement of aldosterone in some gynecological conditions and diseases, characterized by inflammation, hypertension and increased cardio-metabolic risk, such as use of hormonal contraceptives, preeclampsia, polycystic ovary syndrome, uterine fibroids, and endometriosis. The aim of this mini-review is to report the possible involvement of aldosterone in all these gynecological conditions, suggesting different pathogenetic mechanisms and new target treatments of MR blockers for these diseases.

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“…Aldosterone is a major factor in the genesis of many gynecological problems associated with inflammation and autoimmunity A possible link between PCOS and preeclampsia is the finding of activation of RAAS in both these conditions. Aldosterone or aldosterone‐to‐renin ratio (ARR) is increased in PCOS and other gynecological diseases, as endometriosis and uterine fibroids . Actually, the most used treatment of PCOS is hormonal contraceptives (HCs) containing progestin with low or antiandrogen activity, able to block ovarian androgen secretion and resume menstrual abnormalities.…”

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confidence: 99%

Hypertension in pregnancy: Role of body mass index, insulin resistance, aldosterone, and calcium homeostasis

Armanini

Andrisani

Ambrosini

et al. 2019

J of Clinical Hypertension

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In a recent study, Zhuang and coll. 1 have reported that body mass index (BMI) and calcium supplementation during pregnancy play an important role in the development of pregnancy-induced hypertension (PIH) in a large cohort of Chinese women. In particular, the authors reported that overweight and obese women before pregnancy had an increased prevalence of PIH, delivery before 34 gestational weeks, and other obstetric outcomes of PIH. On the contrary, calcium supplementation (about 600 mg per day) during pregnancy was associated with a significant reduction in PIH and other adverse pregnancy-related outcomes.The authors suggested that the reduction in BMI prior pregnancy and the supplementation of calcium during pregnancy could be useful to prevent the risk of hypertension and of its related complications.Several studies have reported that pre-existing maternal hypertension and increased BMI are strongly associated with negative maternal and fetal outcomes. 2 These conditions increase the onset of gestational diabetes, PIH, and preeclampsia, leading to an increased risk of later-life cardiovascular and metabolic disorders. 3 One of the main factors involved in the pathogenesis of all these disorders is insulin resistance. This is a complex pathological condition characterized by an inappropriate sensitivity to insulin hormone in insulin-dependent tissues, due to different and not completely known mechanisms, including oxidative stress, inflammation, insulin receptor mutations, postreceptor defects, and mitochondrial dysfunction. 4 Insulin resistance plays a key role in the pathogenesis of many metabolic disorders, such as type 2 diabetes mellitus, metabolic syndrome, and polycystic ovary syndrome (PCOS). In particular, insulin resistance is often present even in lean PCOS patients 5 and is involved in the increased risk of PCOS women for developing gestational diabetes mellitus, PIH, preeclampsia, and other obstetrics and cardiovascular events during pregnancy compared with healthy controls. 2 For all these reasons, the treatment of insulin resistance must be considered in all women, especially with PCOS or metabolic syndrome, to prevent or reduce the possible related complications.Metformin is one of the most widely used treatments for type 2 diabetes and other comorbidities associated with insulin resistance. It has been shown to improve ovary function and fertility outcomes in women with PCOS and insulin resistance even underwent to assisted reproductive technologies (ART). 6 Even if its use is safe, the exposure of metformin in pregnancy has still not been elucidated.Recent evidence reported inositol as an effective insulin sensitizer that can be used before and during pregnancy, improving not only the metabolic profile, but also the ovulatory functions 7 and preventing the onset of gestational diabetes. 8The treatment with adequate diet and insulin sensitizers and the reduction in BMI within normal range must be considered in all women, especially if seeking pregnancy, to prevent the complications related ...

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Uterine fibroids and risk of hypertension: Implication of inflammation and a possible role of the renin‐angiotensin‐aldosterone system

Cited by 12 publications

References 21 publications

Between Uterine Fibroid and High Cardiovascular Risk in Premenopausal Women

Between Uterine Fibroid and High Cardiovascular Risk in Premenopausal Women

Aldosterone in Gynecology and Its Involvement on the Risk of Hypertension in Pregnancy

Hypertension in pregnancy: Role of body mass index, insulin resistance, aldosterone, and calcium homeostasis

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