Document Detail


Increased sensitivity to angiotensin II is present postpartum in women with a history of hypertensive pregnancy.
MedLine Citation:
PMID:  20308605     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pregnancies complicated by new-onset hypertension are associated with increased sensitivity to angiotensin II, but it is unclear whether this sensitivity persists postpartum. We studied pressor response to infused angiotensin II in 25 normotensive postpartum women in both high- and low-sodium balance. Ten women had a history of hypertensive pregnancy (5 with preeclampsia; 5 with transient hypertension of pregnancy), and 15 women had a history of uncomplicated, normotensive pregnancy. Systolic and diastolic blood pressures, aldosterone, and soluble fms-like tyrosine kinase 1 levels were measured before and after angiotensin II infusion in both dietary phases. In high sodium balance, women with a history of hypertensive pregnancy were normotensive but had significantly higher systolic and diastolic blood pressures than controls (115 versus 104 mm Hg and 73 versus 65 mm Hg, respectively; P<0.05). Women with a history of hypertensive pregnancy had a pressor response to salt loading, demonstrated by an increase in systolic blood pressure on a high-salt diet. They also had greater systolic pressor response (10 versus 2 mm Hg; P=0.03), greater increase in aldosterone (56.8 versus 30.8 ng/dL; P=0.03), and increase in soluble fms-like tyrosine kinase 1 levels (11.0 versus -18.9 pg/mL; P=0.02) after infusion of angiotensin II in low-sodium balance compared with controls. Thus, women with a history of hypertensive pregnancy demonstrated salt sensitivity of blood pressure and had increased pressor, adrenal, and soluble fms-like tyrosine kinase 1 responses to infused angiotensin II in low-sodium balance. Increased sensitivity to angiotensin II observed during pregnancy in women with hypertensive pregnancy is present postpartum; this feature may contribute to future cardiovascular risk in these women.
Authors:
Aditi R Saxena; S Ananth Karumanchi; Nancy J Brown; Caroline M Royle; Thomas F McElrath; Ellen W Seely
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-03-22
Journal Detail:
Title:  Hypertension     Volume:  55     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-15     Completed Date:  2010-05-28     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1239-45     Citation Subset:  IM    
Affiliation:
Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, 221 Longwood Ave, RFB-2, Boston, MA 02115, USA. asaxena@partners.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Angiotensin II / administration & dosage,  pharmacology*
Blood Pressure / drug effects,  physiology
Diet, Sodium-Restricted
Female
Humans
Hypertension, Pregnancy-Induced / physiopathology*
Infusions, Intravenous
Parity
Pregnancy
Pregnancy Complications, Cardiovascular / physiopathology*
Pregnancy Trimester, Third
Reference Values
Sodium / blood
Sodium, Dietary / pharmacology
Systole / drug effects,  physiology
Grant Support
ID/Acronym/Agency:
HL060906/HL/NHLBI NIH HHS; K24 HL096141-06A1/HL/NHLBI NIH HHS; K24 RR0186-13-01/RR/NCRR NIH HHS; K30 RR022292-09/RR/NCRR NIH HHS; K30RR022292-07/RR/NCRR NIH HHS; M01-RR02635/RR/NCRR NIH HHS; T32 HL007609-24/HL/NHLBI NIH HHS; T32HL007609-23/HL/NHLBI NIH HHS; //Howard Hughes Medical Institute; //Howard Hughes Medical Institute
Chemical
Reg. No./Substance:
0/Sodium, Dietary; 11128-99-7/Angiotensin II; 7440-23-5/Sodium
Comments/Corrections

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