ABSTRACT
Background: The changes in endothelial function, arterial stiffness, and heart rate variability (HRV) produced in the first trimester of pregnancy in women who develop gestational hypertension (GH) are still being investigated. Objective: to evaluate the HVR, endothelial function, and arterial stiffness changes during the first trimester of pregnancy and their relationship with the development of GH. Methods: A group of women normotensive during the first trimester (n = 43), who later did (GH; n = 11) or did not (no-GH; n = 32) develop GH in that pregnancy, were enrolled. In the first trimester, endothelial function and arterial stiffness were evaluated through photoplethysmography. HRV, parasympathetic (PNS), and sympathetic (SNS) indexes were measured in a 5-minute continuous electrocardiogram record at rest sitting. The Griess reaction measured urinary nitrite excretion (NOx). Results: Systolic blood pressure (SBP) values were higher in GH (no-GH: 105.8 ± 2.0 vs. GH: 112.7 ± 3.0 mmHg; p < 0.05). Endothelial function was decreased, and arterial stiffness was increased in GH. Only in GH the arterial stiffness was correlated with SBP (Pearson's r: 0.5594; 95%CI: 0.06106-0.8681; p < 0.05). In HRV, GH decreased low-frequency power and the ratio SD2/SD1. The inhibition of PNS was lower in GH. The NOx was reduced in GH (no-GH: 3.4 ± 0.4 vs. GH: 0.3 ± 0.1 µM/L; p < 0.001). NOx was correlated negatively with the SNS index only in GH. Conclusions: Developed GH is preceded early in pregnancy by endothelial dysfunction and increased arterial stiffness. In this context, there are SNS-PNS interrelation modifications with less inhibition of PNS.
ABSTRACT
RESUMEN Introducción: La comunidad Quilmes (Tucumán) abarca 2400 habitantes de media y alta montaña (1800 a 4000 metros sobre el nivel del mar). El objetivo del presente trabajo fue conocer su estado de salud cardiovascular. Material y métodos: Se efectuó una investigación cuantitativa descriptiva transversal en personas pertenecientes a dicha comunidad que asistieron voluntariamente en los días 27 a 29 de septiembre de 2018 a la evaluación prevista. Resultados: Se estudiaron 202 pobladores (125 mujeres y 77 varones; 48 ± 1,4 años). El 23% de ellos tenían hipertensión arterial (HTA); un 14% eran tabaquistas; el 4,9% tenían diabetes (DBT); el 18% presentaba dislipidemia (DLP); el 25% consumía alcohol rutinariamente (1,0 ± 0,4 L/día). Asimismo, el 29% presentaba sobrepeso y el 36% obesidad. Se registró presión arterial (PA) elevada en 48 personas al momento del estudio. La PA disminuyó en la tercera toma con respecto a la primera, pero la frecuencia cardíaca aumentó en la tercera toma (74 ± 1 latidos por minuto vs. 77 ± 1; p <0,01). La saturación de O2 (95,0 ± 0,2%) se correlacionó negativamente con la edad (Pearson r: −0,266; p <0,001). En los pobladores con PA normal, la relación E/A determinada ecográficamente fue mayor (1,2 ± 0,0) y el espesor de la pared posterior del ventrículo izquierdo fue menor (8,5 ± 0.5 mm) que en aquellos con PA elevada (0,92 ± 0,1 y 9,0 ± 0.3, respectivamente, p <0,001). El 24% presentó placas ateroscleróticas y 120 pobladores presentaron DLP. Conclusiones: La población Quilmes presenta una prevalencia de factores de riesgo cardiovascular similar a la de centros urbanos, los que podrían llevar en los próximos años a un incremento de la morbimortalidad cardiovascular en esta población
ABSTRACT Background: The Quilmes community includes 2,400 inhabitants of the middle and high mountains of Tucumán (1,800 to 4,000 meters above sea level). The purpose of the present study was to know their cardiovascular health status. Material and methods: A cross-sectional descriptive quantitative investigation was carried out in people belonging to the Quilmes community who voluntarily attended the planned evaluation on September 27-29, 2018. Results: Two hundred and two settlers were studied (125 women and 77 men; 48 ± 1.4 years), 23% of them had hypertension (HTN); 14% were smokers; 4.9% had diabetes; 18% had dyslipidemia (DLP) and 25% usually consumed alcohol (1.0 ± 0.4 L/day). Also, 29% were overweight and 36% obese. High blood pressure (BP) was recorded in 48 individuals at the time of the study. Blood pressure decreased in the third compared to the first measurement, whereas heart rate increased in the third assessment (74 ± 1 beats per minute vs. 77 ± 1; p <0.01). Oxygen saturation (95.0 ± 0.2%) was negatively correlated with age (Pearson r: −0.266; p <0.001). In individuals with normal BP, ultrasound E/ratio was higher (1.2 ± 0.0) and left ventricular posterior wall thickness was lower (8.5±0.5 mm) than in those with elevated BP (0.92±0.1 and 9.0 ± 0.3, respectively, p <0.001). Twenty-four percent of individuals had atherosclerotic plaques and 120 had DLP. Conclusions: The Quilmes population presents a prevalence of cardiovascular risk factors similar to that of urban centers, which could lead to an increase in cardiovascular morbidity and mortality in the coming years
ABSTRACT
We investigated the effects of extraendothelial nitric oxide (NO) on angiotensin II (Ang II) reactivity in internal mammary artery (IMA) rings, as well as the impact of hypertension without associated risk factors in this response. Vascular reactivity, NO levels, and resting membrane potentials were determined in hypertensive (HT) and normotensive (NT) IMA rings. Only rings with endothelial dysfunction were included. Ang II produced a dose-dependent contraction that was higher in HT rings. Response to Ang II was potentiated by Nω-nitro L-arginine methyl ester (L-NAME) in NT but not in HT rings. The antioxidant agents tempol and diphenyleneiodonium (DPI) reverted the hyperreactivity to Ang II in HT rings. Extraendothelial NO was present in both NT and HT rings. However, NT rings showed higher values. L-NAME and S-methyl-L-thiocitrulline inhibited NO release in all cases. L-arginine reverted this inhibition. Both tempol and DPI increased NO release in both NT and HT rings. The number of vascular smooth muscle cells (VSMC) and anti-α-actin positive areas were lower in HT than in NT rings, without variations in wall thickness or wall/lumen ratio. With regard to resting membrane potential, we found in HT rings that the depolarization induced by Ang II was abolished by tempol. These findings suggest that extraendothelial NO counterregulates Ang II contractility in IMA rings; however, its action could be altered in hypertensive situations even though the patients did not have associated risk factors. We suggest two mechanisms: increased oxidative stress and a decreased ability of nNOS in VSMC to produce NO.
