Does a predisposition to the metabolic syndrome sensitize women to developpre-eclampsia?

Citation
Ae. Barden et al., Does a predisposition to the metabolic syndrome sensitize women to developpre-eclampsia?, J HYPERTENS, 17(9), 1999, pp. 1307-1315
Citations number
30
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
JOURNAL OF HYPERTENSION
ISSN journal
0263-6352 → ACNP
Volume
17
Issue
9
Year of publication
1999
Pages
1307 - 1315
Database
ISI
SICI code
0263-6352(199909)17:9<1307:DAPTTM>2.0.ZU;2-F
Abstract
Objective This study aimed to identify those factors in the non-pregnant st ate that distinguished women who developed pre-eclampsia from those who had normotensive pregnancies. Design and setting This was a retrospective analysis of anthropometry, bloo d pressure, biochemical and haematological variables in 62 women with pre-e clampsia and 84 normotensive pregnant women who took part in studies of the pathophysiology of pre-eclampsia. Pregnant volunteers were seen, after adm ission to hospital or in the outpatient clinic, and followed-up at 6 weeks and 6 months post-partum in the outpatient clinic or their home. Participants Proteinuric pre-eclampsia was defined as blood pressure greate r than or equal to 140/90 mmHg with proteinuria of at least 300 mg/24 h aft er 20 weeks gestation, in women with no history of hypertension and whose b lood pressure returned to normal levels by 6 months post-partum Normotensiv e pregnancy was defined as blood pressure <130/90 mmHg without proteinuria. Main outcome measures The primary outcome measures were blood pressure, bod y mass index (BMI), triglycerides, total cholesterol, low density lipoprote in (LDL) and high density lipoprotein cholesterol and markers of severity o f pre-eclampsia. Results Regardless of parity, women with pre-eclampsia had elevated BMI bef ore, during and after pregnancy compared with women who had normotensive pr egnancies. Triglycerides were significantly elevated in women who had pre-e clampsia both before and after delivery, while total and LDL cholesterol we re elevated significantly at both visits after delivery. Systolic and diast olic blood pressure, which by definition were elevated antepartum in women with pre-eclampsia, remained higher at post-partum visits compared with wom en who had normotensive pregnancies. Women with pre-eclampsia reported a gr eatly increased frequency of both maternal hypertension and pre-eclampsia. Markers of severity of pre-eclampsia, which normalized by 6 months postpart um, included plasma creatinine, uric acid, albumin, endothelin 1 and urinar y protein, 2,3, dinor-6-keto-PGF(1 alpha), blood platelet and neutrophil co unts. Conclusion The relative elevation of blood pressure, BMI and lipids in the non-pregnant state are features of the metabolic syndrome and may be import ant sensitizing factors contributing to the pathogenesis of pre-eclampsia. A familial predisposition to pre-eclampsia may operate partly through these mechanisms. J Hypertens 1999, 17:1307-1315 (C) Lippincott Williams & Wilki ns.