Open AccessCardiorenal continuum in hypertensive pregnancy
Author(s) -
И. Р. Гайсин,
Р. М. Валеева,
Н. И. Максимов
Publication year - 2009
Publication title -
arterialʹnaâ gipertenziâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.126
H-Index - 5
eISSN - 2411-8524
pISSN - 1607-419X
DOI - 10.18705/1607-419x-2009-15-5-590-597
Subject(s) - medicine , cardiorenal syndrome , left ventricular hypertrophy , kidney disease , albuminuria , endocrinology , cohort , cardiology , renal function , ambulatory blood pressure , blood pressure , metabolic syndrome , endothelial dysfunction , eclampsia , obstetrics , pregnancy , obesity , biology , genetics
Risk factors (RF), initial stages, progression, and final stage of both cardiovascular disease (CVD) and chronic kidney disease (CKD) were analyzed in a cohort of 159 pregnant women with hypertensive disorders versus a cohort of 32 healthy pregnant controls. Cardiorenal continuum factors were separately investigated in patients with different gestational hypertension (HT) depending on the diagnostic method: 13 with isolated clinic HT (1CHT), 11 - isolated ambulatory HT (IAHT), and 18 - HT found by all three blood pressure (BP) measurement methods (clinic, ambulatory, and home BP). The number of RF (age, family history of CVD and pre-eclampsia, pre-pregnancy history of smoking, lack of physical exercise, and oral contraception, BP levels, abdominal obesity, dyslipidaemia, anxiety and depression, oxidative stress, altered fasting plasma glucose, metabolic syndrome), signs of subclinical organ damage (cell membrane destabilization, left ventricular hypertrophy, intima-media thickening, slight increase in serum creatinine, hyperuricaemia, endothelial dysfunction, albuminuria, low glomerular filtration rate), and total cardiovascular risk progressively increased from the condition of being normotensive at the time of office, home, and 24-hour measurements to the condition of being found hypertensive by one, two and all three BP measurement methods, forming the continuum «healthy pregnant women - ICHT - IAHT - gestational HT». Assessment of cardiorenal state in all pregnant women allowed to compose the cline «healthy pregnants- gestational HT- stage I essential HT - stage II essential HT - pre-eclampsia - essential HT with superimposed pre-eclampsia» with the growing risk of CVD and CKD and potential danger of cardiovascular events and chronic renal failure.