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(Hypertension. 2004;44:e1.)
© 2004 American Heart Association, Inc.
Hypertension Electronic Pages |
Departamento de Obstetricia/Ginecología, Facultad de Medicina Pontificia Universidad Católica, Santiago, Chile
Departamento de Nefrología, Facultad de Medicina Pontificia Universidad Católica, Santiago, Chile
Departamento de Obstetricia/Ginecología, Facultad de Medicina Pontificia Universidad Católica, Santiago, Chile
Letters to the Editor will be published, if suitable, as space permits. They should not exceed 1000 words (typed double-spaced) in length and may be subject to editing or abridgment.
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
To the Editor:
In the March issue of Hypertension Noris et al describe that preeclamptic women have decreased placental villi L-arginine concentration and overexpression of arginase II.1 In February, Alexander et al reported that supplementing L-arginine in pregnant rats with reduced uterine perfusion decreased blood pressure, concomitantly increasing serum L-arginine levels and urinary nitrite/nitrate.2 Both reports highlight the role of the L-arginine-nitric oxide (NO) pathway in determining normal and preeclamptic pregnancies and sustain the potential benefit of L-arginine supplementation in women at risk of preeclampsia. Although L-arginine has been given acutely to preeclamptic women, there is no concordance about its benefits.3,4 We wish to underscore the benefits of this intervention with our experience with chronic long-term oral L-arginine supplementation in women at risk of placentation-related disorders.
Seventeen women with bilateral notching and high uterine artery resistance in transvaginal ultrasounds performed 2 weeks apart (2 and 0 weeks) were included. Endothelial function was also assessed by high-resolution ultrasound of the brachial artery. Of the 15 multiparas, 3 had presented preeclampsia associated with stillbirth in 2, 5 had unexplained recurrent abortions, 2 had isolated spontaneous abortions, and 1 had a premature delivery of ischemic origin. None presented thrombophilias. L-Arginine supplementation (0.1 g/kg per day PO; Smartbasics, San Francisco, Calif) was started at 10.1±0.9 (SEM) weeks of gestation (week 0), and continued until delivery. After 2 weeks on L-arginine, the womens mean arterial pressure and uterine artery resistance index decreased (75±2 versus 82±3 and
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