Disease relevance of PIH

• RESULTS: Among the PIH patients, positive parental history of hypertension (hypertension in both parents, in mother alone or in father alone) was significantly more frequent than in healthy pregnant women [1].
• BACKGROUND.--Pregnancy-induced hypertension (PIH), defined as either isolated hypertension after the 20th week of gestation or hypertension with proteinuria (preeclampsia), occurs in 5% to 15% of pregnancies and is associated with maternal and neonatal morbidity [2].
• These measures were compared amongst groups, and also within groups for those with PIH, according to the severity of their disorder and the presence of proteinuria or oedema [3].
• CONCLUSIONS: Pvol is related to birth weight, but is reduced in only approximately half of women with PIH [3].
• In addition, the incidence of interictal migraine headache was significantly higher in patients with migraine-like PIH [4].

High impact information on PIH

• Previous clinical trials with small numbers of patients have suggested that aspirin in doses of 60 to 150 mg/d during the second and third trimesters reduces the risk of PIH and improves maternal and neonatal outcomes [2].
• Using PIHP, the kinetics of toxin-cell association at 37 degrees C was resolved into two compounds: surface binding and internalization [5].
• In the second stage, PIHP with doxorubicin 60-120 mg/m2/treatment was planned for a period of 1 to 3 months after surgery [6].
• In the remaining 3 patients, PIHP was abandoned because 2 had rapid disease progression and 1 had liver failure after surgery [6].
• The mean heart weight as a measure of arterial hypertension of patients who died from spontaneous intracerebral hemorrhage (primary intracerebral hemorrhage or PIH) was compared with that of controls from the same autopsy population [7].

Chemical compound and disease context of PIH

• In particular, prospective investigations by at least five groups of investigators have indicated that relative hyperinsulinemia, glucose intolerance, and insulin insensitivity predict the subsequent development of PIH [8].
• Levels of serum uric acid did show a high positive correlation with the severity of PIH in relation to hypertension and proteinuria [9].
• We have measured simultaneously plasma renin activity (PRA), aldosterone and catecholamines in the plasma of 3 groups of pregnant women after the 20th week: group 1 of 16 normotensive controls, group II of 17 women with rest responding hypertension (RRH), group III of 18 women with permanent hypertension (PIH) [10].
• Of the two patients who developed superimposed PIH, one, who received labetalol, developed severe hypertension at 35 weeks, requiring delivery [11].

Biological context of PIH

• Having a CC genotype increased the risk of development of PIH 2.74 times (95% CI, 1.08-6.97) [1].
• CC genotype was significantly more frequent in women with PIH as compared with healthy controls and the C allele frequency was also significantly higher among the cases compared to controls [1].
• Diastolic blood pressure greater than 100 mmHg, persistent proteinuria and severe PIH were the only reliable positive predictors of a reduced Pvol [3].
• OBJECTIVES: Reduction in plasma volume (Pvol) of women with pregnancy-induced hypertension (PIH; preeclampsia) has both physiological and clinical implications [3].
• In the PIH group the antepartum and postpartum COP values were significantly lower (17.9 and 13.7 mm Hg, respectively) than comparable values for the control group (22.0 and 17.2 mm Hg, respectively) [12].

Anatomical context of PIH

• This study was undertaken to determine the following variables in women with PIH: (1) the incidence of reduced Pvol; (2) the distribution of total extracellular fluid volume (ECFV); (3) the relationship between Pvol and birth weight; and (4) whether any readily available clinical or laboratory parameters predict the presence of reduced Pvol [3].
• We believe that serial COP determinations combined with pulmonary artery pressure monitoring may be helpful to guide fluid therapy in critically ill patients with PIH [12].
• The abnormality of lipid composition of the platelet plasma membrane could account for some of the changes in platelet function that have been described in PIH [13].
• It has been recently hypothesized that in PIH a placental oxidant-antioxidant imbalance might cause the release of lipoperoxidation products into the circulation, with subsequent damage of endothelial cell membranes [14].
• In PIH microvillus membrane we also observed a significant increase of the content of polyunsaturated arachidonic acid [14].

Associations of PIH with chemical compounds

• Blood pressure, haematocrit, uric acid and serum albumin were also evaluated as predictive indices of reduced Pvol in women with PIH [3].
• The IC50s for Ga-PIH, gallium nitrate and PIH were 60, 84 and 68 microM respectively [15].
• At 50 microM, Ga-PIH inhibited CCRF-CEM cell growth by 45% compared to < 10% inhibition with gallium nitrate or PIH [15].
• In order to investigate this issue, we studied the basal content of lipid peroxides in terms of malondialdehyde (MDA) in the syncytiotrophoblast plasma membranes (SPM) from PIH women [14].
• Serotonin release from platelets was decreased and reserpine-induced release-reaction showed enhanced kinetics in PIH [16].

Other interactions of PIH

• CONCLUSION: On the basis of the results of our study, we may suggest that AGTR1 gene A1166C polymorphism may predispose women to the development of PIH [1].
• The ratio between activin A and follistatin was significantly increased in patients with PIH (1.5 MoM) and was further increased in patients with pre-eclampsia (4.5 MoM) and in the group with pre-eclampsia+IUGR (2.6 MoM) [17].
• Follistatin levels were positively correlated with gestational age in control subjects (r=0. 36, P<0.05) and in patients with PIH (r=0.46, P<0.05) or pre-eclampsia (r=0.61, P<0.01), while activin A correlated with gestational age only in the healthy control group (r=0.69, P<0.0001) [17].
• RESULTS: VCAM-1 was significantly elevated in women developing hypertensive diseases as compared to normotensive women (preeclampsia: p<0.001; PIH: p<0.05; chronic hypertension: p<0.001) [18].
• The process of bone turnover is regulated by hormones, such as PIH and local factors such as IL-1 and prostaglandins [19].

Analytical, diagnostic and therapeutic context of PIH

• OBJECTIVE.--We performed a meta-analysis of the six published controlled trials to estimate more precisely (1) the magnitude of protection of aspirin from PIH; (2) the effect of aspirin on severe low-birth-weight infants, cesarean section, and perinatal mortality; and (3) the risk of adverse effects [2].
• CONCLUSION.--This meta-analysis suggests that low-dose aspirin reduces the risks of PIH and severe low birth weight, with no observed risk of maternal or neonatal adverse effects [2].
• STUDY DESIGN: This was a cross-sectional study among third-trimester pregnancies with preeclampsia (PIH) compared with normotensive controls [20].
• Until noninvasive measures with acceptable-sensitivity and specificity are available for differential diagnosis, frustration in etiologic research on PIH is likely to continue [21].
• A retrospective study was made to determine the incidence of pregnancy-induced hypertension (PIH, pre-eclampsia) in Iceland [22].

References