+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Risk factors and mediators of the vascular dysfunction associated with hypertension in pregnancy

Risk factors and mediators of the vascular dysfunction associated with hypertension in pregnancy

Cardiovascular and Hematological Disorders Drug Targets 10(1): 33-52

Normal pregnancy is associated with significant hemodynamic changes and vasodilation in the uterine and systemic circulation in order to meet the metabolic demands of the mother and developing fetus. Hypertension in pregnancy (HTN-Preg) and preeclampsia (PE) are major complications and life-threatening conditions to both the mother and fetus. PE is precipitated by various genetic, dietary and environmental factors. Although the initiating events of PE are unclear, inadequate invasion of cytotrophoblasts into the uterine artery is thought to reduce uteroplacental perfusion pressure and lead to placental ischemia/hypoxia. Placental hypoxia induces the release of biologically active factors such as growth factor inhibitors, anti-angiogenic proteins, inflammatory cytokines, reactive oxygen species, hypoxia-inducible factors, and antibodies to vascular angiotensin II receptor. These bioactive factors affect the production/activity of various vascular mediators in the endothelium, smooth muscle and extracellular matrix, leading to severe vasoconstriction and HTN. As an endothelial cell disorder, PE is associated with decreased vasodilator mediators such as nitric oxide, prostacyclin and hyperpolarizing factor and increased vasoconstrictor mediators such as endothelin, angiotensin II and thromboxane A(2). PE also involves enhanced mechanisms of vascular smooth muscle contraction including intracellular free Ca(2+) concentration ([Ca(2+)](i)), and [Ca(2+)](i) sensitization pathways such as protein kinase C, Rho-kinase and mitogen-activated protein kinase. Changes in extracellular matrix composition and matrix metalloproteases activity also promote vascular remodeling and further vasoconstriction in the uterine and systemic circulation. Characterization of the predisposing risk factors, the biologically active factors, and the vascular mediators associated with PE holds the promise for early detection, and should help design specific genetic and pharmacological tools for the management of the vascular dysfunction associated with HTN-Preg.

(PDF emailed within 1 workday: $29.90)

Accession: 055579185

Download citation: RISBibTeXText

PMID: 20041838

Related references

Interactions of Biologically Active Factors and Vascular Mediators During Hypertension in Pregnancy. Current Hypertension Reviews 3(4): 231-241, 2007

Genetic, immune and vasoactive factors in the vascular dysfunction associated with hypertension in pregnancy. Expert Opinion on Therapeutic Targets 19(11): 1495-1515, 2016

Cellular mediators of renal vascular dysfunction in hypertension. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology 296(4): R1001-R1018, 2009

Endothelial dysfunction on initial stages of arterial hypertension among men of young age and it's connection with vascular risk factors. Voenno-Meditsinskii Zhurnal 331(4): 20-25, 2010

Role of inflammatory and hemostatic mediators in preclinical endothelial dysfunction Relevance to high-risk patients with hypertension. Journal of the American College of Cardiology 39(5 Supplement A): 209A-210A, March 6, 2002

Work-related maternal risk factors and the risk of pregnancy induced hypertension and preeclampsia during pregnancy. The Generation R Study. Plos One 7(6): E39263, 2012

Risk factors for pregnancy-induced hypertension in women at high risk for the condition. Italian Study of Aspirin in Pregnancy Group. Epidemiology 7(3): 306-308, 1996

Correlation and risk factors between vascular endothelial dysfunction and erectile dysfunction. Beijing Da Xue Xue Bao. Yi Xue Ban 42(4): 418-420, 2011

Factors in the prevention of cardio-vascular diseases--Part 1: 96 cardio-vascular risk factors, with special emphasis on the prevention and treatment of hypertension, controllable dietary risk factors, and recommended U.S. dietary goals. Acupuncture and Electro-Therapeutics Research 7(2-3): 57-92, 1982

Pathophysiology of Cerebral Vascular Dysfunction in Pregnancy-Induced Hypertension. Current Hypertension Reports 21(7): 52, 2019

Factors in the prevention of cardio vascular disease 1. 96 cardio vascular risk factors with special emphasis on the prevention and treatment of hypertension controllable dietary risk factors and recommended usa dietary goals. Acupuncture & Electro-Therapeutics Research 7(2-3): 57-92, 1982

Prepregnancy Vascular Dysfunction in Women who Subsequently Develop Hypertension During Pregnancy. Pregnancy Hypertension 3(2): 140-145, 2013

The effect of vascular risk factors on penile vascular status in men with erectile dysfunction. Journal of Urology 178(6): 2516-20; Discussion 2520, 2007

Role of vascular risk factors and vascular dysfunction in Alzheimer's disease. Mount Sinai Journal of Medicine, New York 77(1): 82-102, 2010

Role of Renin-Angiotensin System in Vascular Endothelial Dysfunction of Pregnancy-Induced Hypertension. Current Hypertension Reviews 2(4): 311-316, 2006