Key result
Pregnancy-induced hypertension is linked to ~70% lower labile plasma volume and higher uric acid.
Why the study?
The pathophysiological differences in plasma renin activity, blood uric acid, and plasma volume between labile and permanent pregnancy-induced hypertension were unclear.
Observational (n=40)
Labile and permanent pregnancy-induced hypertension exhibit different pathophysiological profiles, with renin secretion in permanent hypertension being inappropriately low for the degree of hypovolemia.
Answers are grounded in this paper and cite their sources.
May prompt plasma volume assessment in PIH; leaves open whether expansion improves outcomes.
UNLABELLED: Plasma renin activity (PRA), plasma aldosterone (PA), blood uric acid (BUA), plasma concentrations of catecholamines (Pcat) and plasma volume (PV) were measured simultaneously in 24 patients with pregnancy-induced hypertension. This hypertensive group was divided into labile (LH) and permanent hypertension (PH) groups according to the response of their blood pressure to home bed rest. As compared to normal theoretical values, PV was decreased in both hypertensive groups (LH = -70%; PH = -14%). As compared to a control group of 16 normotensive pregnant women, PRA was higher in LH and lower in PH whereas PA was lower in both hypertensive groups. In both hypertensive groups, BUA was higher than in the control group. No difference in Pcat was found between the three groups. In the PH group negative correlations were found between BUA and PRA, as well as between BUA and PV, but no correlation between PRA and PV nor between Pcat and BUA were found. CONCLUSIONS: LH and PH are two pathophysiologically different entities in pregnancy-induced hypertension. In PH, renin secretion is not appropriate to hypovolemia and therefore not primarily involved in the pathogenesis of hypertension. The role of hypovolemia in the increase of BUA may be discussed.
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Fiévet et al. (2008) conducted an observational in Pregnancy-induced hypertension (n=40). Pregnancy-induced hypertension vs. Normotensive pregnant women was evaluated on Plasma renin activity, plasma aldosterone, blood uric acid, plasma catecholamines, and plasma volume. Pregnancy-induced hypertension was associated with decreased plasma volume (labile -70%, permanent -14%) and increased blood uric acid compared to normotensive pregnant women.
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