This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Solomon, C. G. Articles by Seely, E. W. Search for Related Content PubMed PubMed Citation Articles by Solomon, C. G. Articles by Seely, E. W. Pubmed/NCBI databases Medline Plus Health Information High Blood Pressure High Risk Pregnancy Related Collections Other hypertension

(Hypertension. 2001;37:232.)
© 2001 American Heart Association, Inc.

Scientific Contributions

Brief Review: Hypertension in Pregnancy

A Manifestation of the Insulin Resistance Syndrome?

Caren G. Solomon; Ellen W. Seely

From the Division of Women’s Health (C.G.S.) and the Endocrine-Hypertension Division (C.G.S., E.W.S.), Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass.

Correspondence to Caren G. Solomon, MD, Women’s Health Center, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115. E-mail cgsolomon{at}bics.bwh.harvard.edu

Pregnancy-induced hypertension (PIH), which includes both gestational hypertension and preeclampsia, is a common and morbid pregnancy complication for which the pathogenesis remains unclear. Emerging evidence suggests that insulin resistance, which has been linked to essential hypertension, may play a role in PIH. Conditions associated with increased insulin resistance, including gestational diabetes, polycystic ovary syndrome, and obesity, may predispose to hypertensive pregnancy. Furthermore, metabolic abnormalities linked to the insulin resistance syndrome are also observed in women with PIH to a greater degree than in normotensive pregnant women: These include glucose intolerance, hyperinsulinemia, hyperlipidemia, and high levels of plasminogen activator inhibitor-1, leptin, and tumor necrosis factor-. These observations suggest the possibility that insulin resistance may be involved in the pathogenesis of PIH and that approaches that improve insulin sensitivity might have benefit in the prevention or treatment of this syndrome, although this requires further study.

Key Words: preeclampsia • hypertension, gestational • insulin resistance • hypertension, pregnancy

This article has been cited by other articles:

				J. M. Roberts and H. S. Gammill Preeclampsia: Recent Insights Hypertension, December 1, 2005; 46(6): 1243 - 1249. [Abstract] [Full Text] [PDF]

				E. Kajantie, R. Kaaja, O. Ylikorkala, S. Andersson, and H. Laivouri Adiponectin Concentrations in Maternal Serum: Elevated in Preeclampsis But Unrelated to Insulin Sensitivity Reproductive Sciences, September 1, 2005; 12(6): 433 - 439. [Abstract] [PDF]

				R. D'Anna, G. Baviera, F. Corrado, D. Giordano, A. Di Benedetto, and V. M. Jasonni Plasma Adiponectin Concentration in Early Pregnancy and Subsequent Risk of Hypertensive Disorders Obstet. Gynecol., August 1, 2005; 106(2): 340 - 344. [Abstract] [Full Text] [PDF]

				M. Wolf, C. A. Hubel, C. Lam, M. Sampson, J. L. Ecker, R. B. Ness, A. Rajakumar, A. Daftary, A. S. M. Shakir, E. W. Seely, et al. Preeclampsia and Future Cardiovascular Disease: Potential Role of Altered Angiogenesis and Insulin Resistance J. Clin. Endocrinol. Metab., December 1, 2004; 89(12): 6239 - 6243. [Abstract] [Full Text] [PDF]

				A. Pouta, A.-L. Hartikainen, U. Sovio, M. Gissler, J. Laitinen, M. I. McCarthy, A. Ruokonen, P. Elliott, and M.-R. Jarvelin Manifestations of Metabolic Syndrome After Hypertensive Pregnancy Hypertension, April 1, 2004; 43(4): 825 - 831. [Abstract] [Full Text] [PDF]

				R. A. Bazaes, A. Alegria, E. Pittaluga, A. Avila, G. Iniguez, and V. Mericq Determinants of Insulin Sensitivity and Secretion in Very-Low-Birth-Weight Children J. Clin. Endocrinol. Metab., March 1, 2004; 89(3): 1267 - 1272. [Abstract] [Full Text] [PDF]

				C. L. Bryson, G. N. Ioannou, S. J. Rulyak, and C. Critchlow Association between Gestational Diabetes and Pregnancy-induced Hypertension Am. J. Epidemiol., December 15, 2003; 158(12): 1148 - 1153. [Abstract] [Full Text] [PDF]

				K. E. Innes, T. E. Byers, J. A. Marshall, A. Baron, M. Orleans, and R. F. Hamman Association of a Woman's Own Birth Weight with Her Subsequent Risk for Pregnancy-induced Hypertension Am. J. Epidemiol., November 1, 2003; 158(9): 861 - 870. [Abstract] [Full Text] [PDF]

				N. Sattar, J. Ramsay, L. Crawford, H. Cheyne, and I. A. Greer Classic and Novel Risk Factor Parameters in Women With a History of Preeclampsia Hypertension, July 1, 2003; 42(1): 39 - 42. [Abstract] [Full Text] [PDF]

				M. Wolf, L. Sandler, R. Jimenez-Kimble, A. Shah, J. L. Ecker, and R. Thadhani Insulin Resistance But Not Inflammation Is Associated With Gestational Hypertension Hypertension, December 1, 2002; 40(6): 886 - 891. [Abstract] [Full Text] [PDF]

				X. Yang, B. Hsu-Hage, H. Zhang, C. Zhang, Y. Zhang, and C. Zhang Women With Impaired Glucose Tolerance During Pregnancy Have Significantly Poor Pregnancy Outcomes Diabetes Care, September 1, 2002; 25(9): 1619 - 1624. [Abstract] [Full Text] [PDF]

				M. Wolf, L. Sandler, K. Munoz, K. Hsu, J. L. Ecker, and R. Thadhani First Trimester Insulin Resistance and Subsequent Preeclampsia: A Prospective Study J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1563 - 1568. [Abstract] [Full Text] [PDF]