RENIN-ALDOSTERONE RELATIONSHIPS IN PREGNANCY-INDUCED HYPERTENSION

被引：71

作者：

BROWN, MA

ZAMMIT, VC

MITAR, DA

WHITWORTH, JA

机构：

[1] Department of Renal Medicine and School of Medicine, University of New South Wales, Sydney, NSW, St. George Hospital

来源：

AMERICAN JOURNAL OF HYPERTENSION | 1992年 / 5卷 / 06期

关键词：

RENIN; ALDOSTERONE; ANGIOTENSIN-II; PREGNANCY; ADRENAL GLANDS; PREGNANCY-INDUCED HYPERTENSION;

D O I：

10.1093/ajh/5.6.366

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

The relationship between plasma renin (PRC) and aldosterone (PAC) concentrations was determined in 83 normal third trimester pregnant women (P), 50 women with pregnancy-induced hypertension (PIH), and 80 age-matched nonpregnant women not taking oral contraceptives (NP). Normal pregnant women had a slightly higher 24-h urine sodium: creatinine ratio than the other groups (P < .001) (NP: 10 +/- 4 v P: 15 +/- 8 v PIH: 12 +/- 7; mean +/- SD). Both PRC and PAC were higher in normal pregnant women as was the ratio PAC:PRC [normal pregnant 195 (158 to 337) v nonpregnant 130 (101 to 209), median (interquartile range); P < .001]. This was accompanied by a slightly reduced slope (sensitivity) of the logPRC-logPAC relationship in normal pregnant women (P < .05). Women with PIH had reduced PRC and PAC compared with normal pregnant women but a two-fold greater increase in PAC:PRC ratio [PIH 411 (277 to 598) v normal pregnancy 195 (158 to 337), P < .001], with a rise in the slope (sensitivity) of the logPRC-logPAC relationship in women with PIH (P < .001). Thus there is proportionately greater aldosterone release in the third trimester of normal pregnancy than in nonpregnant women. This preferential increase in aldosterone may be due to altered adrenal sensitivity to angiotensin II or may reflect enhanced nonangiotensin stimulation of aldosterone during pregnancy. Women with PIH have reduced PRC and PAC but relatively greater stimulation of aldosterone than normal pregnant women, possibly due to enhanced sensitivity of the adrenal glands to angiotensin II.

引用

页码：366 / 371

页数：6

共 38 条

[1]

Brown M.A., Sodium balance in pregnancy, Fetal Medicine, 1, pp. 198-212, (1989)

[2]

Broughton Pipkin F., The renin-angiotensin system in normal and hypertensive pregnancies, Handbook of Hypertension, 10, pp. 118-151, (1988)

[3]

Broughton Pipkin F., Oats J., Symonds E.M., Sequential changes in the human renin-angiotensin system following delivery, Br J Obstet Gynaecol, 85, pp. 821-827, (1978)

[4]

Symonds E.M., Broughton Pipkin F., Craven D.J., Changes in the renin-angiotensin system in primigravidae with hypertensive disease of pregnancy, Br J Obstet Gynaecol, 82, pp. 643-650, (1975)

[5]

Brown M.A., Nicholson E., Ross M.R., Et al., Progressive resetting of sodium-renin-aldosterone relationships in human pregnancy, Clin Exp Hypertens, B5, pp. 349-374, (1987)

[6]

Brown M.A., Gallery E.D.M., Ross M.R., Esber R.P., Sodium excretion in normal and hypertensive pregnancy: A prospective study, Am J Obstet Gynecol, 159, pp. 297-307, (1988)

[7]

Karlberg B.E., Ryden G., Wichman K., Changes in the renin-angiotensin-aldosterone and kallikrein-kininsystems during normal and hypertensive pregnancy, Acta Obstet Gynecol Scand, 118, pp. 17-24, (1984)

[8]

Brown J.J., Davies D.L., Doak P.B., Et al., Plasma renin concentration in the hypertensive diseases of pregnancy, Br J Obstet Gynaecol, 73, pp. 410-417, (1966)

[9]

Weir R.J., Brown J.J., Fraser R., Et al., Plasma renin, renin substrate, angiotensin II and aldosterone in hypertensive disease of pregnancy, Lancet, 1, pp. 291-294, (1973)

[10]

Nicholson E.G., Gallery E., Brown M.A., Et al., Renin activation in normal and hypertensive human pregnancy, Clin Exp Hypertens, B6, pp. 453-464, (1988)

← 1 2 3 4 →