Endothelial function in pregnant women with chronic hypertension and abdominal obesity
https://doi.org/10.29001/2073-8552-2020-35-1-100-106
Abstract
Objective. To evaluate endothelial function in pregnant women with chronic hypertension and abdominal obesity.
Material and Methods. We studied 30 pregnant women with chronic hypertension and abdominal obesity (group I), 28 pregnant women with chronic hypertension and normal body mass index (group IIa), 27 pregnant women with abdominal obesity without chronic hypertension (group IIb), and 33 pregnant women without chronic hypertension and abdominal obesity (control group). We performed reactive hyperemia tests, assessed the serum levels of endothelin-1 and homocysteine, and analyzed the outcomes of pregnancy and delivery.
Results. The values of endothelium-dependent vasodilation (EDVD) in pregnant women of groups I, IIa, and IIb were comparable and were 6.7 (3.2–9.1)%, 7.0 (3.9–11.4)%, and 7.2 (4.4–10.8)%, respectively. Significant differences were found in EDVD values between the groups mentioned above and the control group, where the EDVD value was 12.5 (10.5–13.9)%, p < 0.05. The endothelin-1 concentration in group I was 14.0 (10.3–17.5) pg/mL, which significantly exceeded the corresponding values in group IIa (p < 0.05) and the control group (p < 0.05). The endothelin-1 level in patients with abdominal obesity was twice higher than the corresponding value in the control group (p < 0.05). Significant differences were observed between patients with chronic hypertension (groups I and IIa) and control group (p < 0.05). The level of homocysteine in control group [6.1 (3.9; 8.0) µmol/L] significantly differed from the corresponding values in group I [9.3 (7.8; 10.5) µmol/L, p < 0.05], group IIa [7.8 (6.8; 9.8) µmol/L, p < 0.05], and group IIb [7.8 (6.8; 9.8) µmol/L, p < 0.05].
Conclusions.This study showed the presence of endothelial dysfunction in pregnant women with chronic arterial hypertension and abdominal obesity. This observation was confirmed by the lower values of EDVD, higher frequency of attenuated and paradoxical responses to the reactive hyperemia test, and the elevated serum levels of homocysteine and endothelin-1 in this category of patients. The endothelial dysfunction contributed to the development of pregnancy complications and adverse outcomes of pregnancy compared with the control group and women who had isolated manifestations of chronic
hypertension and abdominal obesity.
Material and Methods. We studied 30 pregnant women with chronic hypertension and abdominal obesity (group I), 28 pregnant women with chronic hypertension and normal body mass index (group IIa), 27 pregnant women with abdominal obesity without chronic hypertension (group IIb), and 33 pregnant women without chronic hypertension and abdominal obesity (control group). We performed reactive hyperemia tests, assessed the serum levels of endothelin-1 and homocysteine, and analyzed the outcomes of pregnancy and delivery.
Results. The values of endothelium-dependent vasodilation (EDVD) in pregnant women of groups I, IIa, and IIb were comparable and were 6.7 (3.2–9.1)%, 7.0 (3.9–11.4)%, and 7.2 (4.4–10.8)%, respectively. Significant differences were found in EDVD values between the groups mentioned above and the control group, where the EDVD value was 12.5 (10.5–13.9)%, p < 0.05. The endothelin-1 concentration in group I was 14.0 (10.3–17.5) pg/mL, which significantly exceeded the corresponding values in group IIa (p < 0.05) and the control group (p < 0.05). The endothelin-1 level in patients with abdominal obesity was twice higher than the corresponding value in the control group (p < 0.05). Significant differences were observed between patients with chronic hypertension (groups I and IIa) and control group (p < 0.05). The level of homocysteine in control group [6.1 (3.9; 8.0) µmol/L] significantly differed from the corresponding values in group I [9.3 (7.8; 10.5) µmol/L, p < 0.05], group IIa [7.8 (6.8; 9.8) µmol/L, p < 0.05], and group IIb [7.8 (6.8; 9.8) µmol/L, p < 0.05].
Conclusions.This study showed the presence of endothelial dysfunction in pregnant women with chronic arterial hypertension and abdominal obesity. This observation was confirmed by the lower values of EDVD, higher frequency of attenuated and paradoxical responses to the reactive hyperemia test, and the elevated serum levels of homocysteine and endothelin-1 in this category of patients. The endothelial dysfunction contributed to the development of pregnancy complications and adverse outcomes of pregnancy compared with the control group and women who had isolated manifestations of chronic
hypertension and abdominal obesity.
About the Authors
A. Yu. Zakharko
Republican Scientific and Practical Center for Radiation Medicine and Human Ecology
Belarus
Belarus
M.D., Cand. Sci. (Med.), Gynecologist
290, Ilicha str., Gomel, 246040, Republic of Belarus
N. P. Mitkovskaya
Belarusian State Medical University
Belarus
Belarus
M.D., Dr. Sci. (Med.), Professor, Head of the Department of Cardiology and Internal Diseases
83, Dzerzhinski ave., Minsk, 220116, Republic of Belarus
L. V. Kartun
Belarusian State Medical University
Belarus
Belarus
Senior Research Scientist, Laboratory of Biochemical Research
83, Dzerzhinski ave., Minsk, 220116, Republic of Belarus
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Review
For citations:
Zakharko A.Yu., Mitkovskaya N.P., Kartun L.V. Endothelial function in pregnant women with chronic hypertension and abdominal obesity. Siberian Journal of Clinical and Experimental Medicine. 2020;35(1):100-106. (In Russ.) https://doi.org/10.29001/2073-8552-2020-35-1-100-106
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