Renin-angiotensin-aldosterone system in normal and hypertensive pregnancy. Response to postural stimuli
| Autor: | C C Lamas, E A Francischetti, Fagundes Vg |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Adult
Mean arterial pressure medicine.medical_specialty Supine position Adolescent Posture Pregnancy Complications Cardiovascular Blood Pressure Plasma renin activity Renin-Angiotensin System Orthostatic vital signs Pregnancy Internal medicine Recumbent Position Renin–angiotensin system Renin Internal Medicine medicine Humans Aldosterone medicine.diagnostic_test business.industry Sodium medicine.disease Endocrinology Hypertension Cardiology Female Renal biopsy business |
| Zdroj: | Hypertension (Dallas, Tex. : 1979). 19 |
| ISSN: | 0194-911X |
| Popis: | Most studies that have attempted to distinguish pregnancy-induced hypertension from chronic hypertension in pregnancy include arbitrary clinical definitions and morphological reports based on renal biopsy. To evaluate whether these conditions have different responses to stimuli to the renin-angiotensin-aldosterone system, we studied four normal nonpregnant women, eight normal pregnant women, 10 women with pregnancy-induced hypertension, and 14 with chronic hypertension in pregnancy, in the third trimester of pregnancy, after they had sequentially adopted the supine, the left lateral recumbent, and the orthostatic positions for 90 minutes each. Postural maneuvers did not significantly change mean arterial pressure in pregnancy-induced hypertensive or in normal pregnant women, although in chronic hypertensive women, a significant reduction in this parameter was observed in left lateral recumbency. The renin-angiotensin-aldosterone system was significantly less activated with women in the supine position in pregnancy-induced hypertensive and chronic hypertensive women; however, as opposed to pregnancy-induced hypertensive women, those with chronic hypertension reassumed their humoral response to upright posture, which was accompanied by a significant reduction in sodium excretion. The parallelism between plasma renin activity and aldosterone levels, absent in normal pregnancy, returned in pregnancy-induced hypertensive and chronic hypertensive women in the erect posture (r = 0.73, p less than 0.01; r = 0.68, p less than 0.01, respectively). These data suggest that the adoption of the left lateral recumbent position in pregnancy reduces mean arterial pressure only in chronic hypertensive women. Moreover, in chronic hypertension, the upright position provoked a significant response of the renin-angiotensin-aldosterone system. This effect was not observed in women with pregnancy-induced hypertension. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|