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(Hypertension. 1997;30:247-251.)
© 1997 American Heart Association, Inc.
Articles |
Flow-Mediated Vasodilatation Is Enhanced in Normal Pregnancy but Reduced in Preeclampsia
From the Fetal Health Research Group, United Medical and Dental Schools, Division of Obstetrics and Gynaecology, St Thomas' Hospital, London, UK.
Correspondence to Prof L. Poston, Fetal Health Research Group, Division of Obstetrics and Gynaecology, St Thomas' Hospital, London SE1 7EH, UK. E-mail l.poston{at}umds.ac.uk
Abstract Endothelium-derived nitric oxide is
proposed to play an important role in the lowering of
peripheral vascular resistance in normal pregnancy. In
women with preeclampsia, the function of the
endothelium is compromised, and it is suggested that
reduced nitric oxide synthesis may contribute to the elevation of blood
pressure and activation of coagulation pathways. In this study, we have
compared responses to increments of intraluminal flow, considered to be
a physiological stimulus to nitric oxide release,
in arteries from normotensive nonpregnant and pregnant women and women
with preeclampsia. Small subcutaneous arteries from normotensive
pregnant women showed substantial flow-induced relaxation, which was
attenuated by the nitric oxide synthase inhibitor
N
-nitro-L-arginine methyl ester
(L-NAME) (mean relaxation, 48.3±8.0% [absence of L-NAME] versus
19.2±10.6% [presence of L-NAME]), whereas those from nonpregnant
women and women with preeclampsia demonstrated modest constriction
(mean constriction, 10.1±7.3% and 1.2±7.2%, respectively). Shear
stress, the frictional force that is the stimulus for flow responses,
was calculated from parameters of flow, viscosity, and
artery diameter. Arteries from pregnant women showed greater relaxation
to shear than those from nonpregnant women or those with preeclampsia.
We conclude that flow-induced shear stress is a potent stimulus to
vasodilatation in arteries from pregnant women and that this mechanism
may lead to a fall in peripheral vascular resistance
in normal pregnancy. Failure of this flow-induced dilatation may
contribute to the gestational hypertension of preeclampsia.
Key Words: flow • nitric oxide • preeclampsia • pregnancy • shear stress • resistance artery
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