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

Journal of Human Hypertension volume 18, pages 789–794 (2004)Cite this article

Abstract

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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References

  1. Gant NF et al. A study of angiotensin II pressor response throughout primigravid pregnancy. J Clin Invest 1973; 52: 2682–2689.

    Article  CAS  Google Scholar 

  2. Brown MA, Gallery ED, Ross MR, Esber RP . Sodium excretion in normal and hypertensive pregnancy: a prospective study. Am J Obstet Gynecol 1988; 159: 297–307.

    Article  CAS  Google Scholar 

  3. Lyall F, Greer IA . Pre-eclampsia: a multifaced vascular disorder of pregnancy. J Hypertens 1994; 12: 1339–1345.

    CAS  PubMed  Google Scholar 

  4. Broughton Pipkin F . The hypertensive disorders of pregnancy. BMJ 1995; 311: 609–613.

    Article  CAS  Google Scholar 

  5. Schobel HP et al. Preeclampsia—a state of sympathetic overactivity. N Engl J Med 1996; 335: 1480–1485.

    Article  CAS  Google Scholar 

  6. Greenwood JP et al. Sympathetic neural mechanisms in normal and hypertensive pregnancy in humans. Circulation 2001; 104: 2200–2204.

    Article  CAS  Google Scholar 

  7. Kaaja RJ et al. Blood pressure and vasoactive hormones in mild Pre-eclampsia and normal pregnancy. Hypertens Pregnancy 1999; 18: 173–187.

    Article  CAS  Google Scholar 

  8. National High Blood Pressure Education Program Working Group Report on High Blood Pressure in Pregnancy. Am J Obstet Gynecol 1990; 163: 1689–1712.

  9. Yandle TG, Espiner EA, Nicholls MG, Duff H . Radioimmunoassay and characterization of atrial natriuretic peptide in human plasma. J Clin Endocrinol Metab 1986; 63: 72–79.

    Article  CAS  Google Scholar 

  10. Yandle TG et al. Assay for brain natriuretic peptide (BNP) in human plasma: evidence for high molecular weight BNP as a major plasma component in heart failure. J Clin Endocrinol Metab 1993; 76: 832–838.

    CAS  PubMed  Google Scholar 

  11. Dunn PJ, Espiner EA . Outpatient screening tests for primary aldosteronism. Aust NZ J Med 1976; 6: 131–135.

    Article  CAS  Google Scholar 

  12. Lun S, Espiner EA, Nicholls MG, Yandle TG . A direct radioimmunoassay for aldosterone in plasma. Clin Chem 1983; 29: 268–271.

    CAS  PubMed  Google Scholar 

  13. Eisenhofer G et al. Simultaneous liquid chromatography determination of 3,4-dihydroxyphenylglycol, catecholamines, and 3,4-dihydroxyphenylalanine in plasma, and their responses to inhibition of monoamine oxidase. Clin Chem 1986; 32: 2030–2033.

    CAS  PubMed  Google Scholar 

  14. Esler MD et al. Noradrenaline release and sympathetic nervous system activity. J Hypertens 1985; 3: 117–129.

    Article  CAS  Google Scholar 

  15. Viktor RG, Mark AL . The sympathetic nervous system in human hypertension. In: Laragh JH, Brenner BM (eds). Hypertension: Pathophysiology, Diagnosis and Management. 2nd ed. Raven Press: New York, 1995 pp 863–878.

    Google Scholar 

  16. Polonia J et al. Renin-angiotensin-aldosterone, sympathetic and endothelin systems in normal and hypertensive pregnancy: response to postural and volume load stimuli. J Hypertens 1993; 11(Suppl 5): S242–S243.

    CAS  Google Scholar 

  17. August P . The renin–angiotensin–aldosterone system in hypertension in human pregnancy. In: Robertson JIS, Nicholls MG (eds). The Renin–Angiotensin System. Gower Medical Publishing: London, 1993, pp 52.1–52.12.

    Google Scholar 

  18. Stella A, Zanchetti A . Neural control of renin secretion. J Hypertens 1984; 2(Suppl 1): 83–87.

    CAS  Google Scholar 

  19. Castro LC, Hobel CJ, Gornbein J . Plasma levels of atrial natriuretic peptide in normal and hypertensive pregnancies: a meta-analysis. Am J Obstet Gynecol 1994; 171: 1642–1651.

    Article  CAS  Google Scholar 

  20. Itoh H et al. Plasma brain natriuretic peptide level in pregnant women with pregnancy-induced hypertension. Obstet Gynecol 1993; 82: 71–77.

    CAS  PubMed  Google Scholar 

  21. Gant NF et al. A clinical test useful for predicting the development of acute hypertension in pregnancy. Am J Obstet Gynecol 1974; 120: 1–7.

    Article  CAS  Google Scholar 

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Acknowledgements

Financial support for this study was from a Helsinki University Central Hospital Research Grant and a Paarvo Nurmi Foundation Grant.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland

    R J Kaaja & A Leinonen

  2. Department of Medicine, Christchurch School of Medicine, Christchurch, New Zealand

    P Moore, T Yandle & C M Frampton

  3. Department of Internal Medicine, UAE University, Al Ain, United Arab Emirates

    M G Nicholls

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  1. R J Kaaja
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  2. A Leinonen
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  4. T Yandle
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  5. C M Frampton
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  6. M G Nicholls
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Correspondence to R J Kaaja.

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Kaaja, R., Leinonen, A., Moore, P. et al. Effect of changes in body posture on vasoactive hormones in pre-eclamptic women. J Hum Hypertens 18, 789–794 (2004). https://doi.org/10.1038/sj.jhh.1001743

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