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Sympathetic nerve discharge in normal pregnancy and pregnancy‐induced hypertension

 

作者: John Greenwood,   John Stoker,   James Walker,   David Mary,  

 

期刊: Journal of Hypertension  (OVID Available online 1998)
卷期: Volume 16, issue 5  

页码: 617-624

 

ISSN:0263-6352

 

年代: 1998

 

出版商: OVID

 

关键词: muscle sympathetic nerve activity;pregnancy-induced hypertension;microneurography

 

数据来源: OVID

 

摘要:

BackgroundMicroneurographic assessment of processed bursts that represent multi-unit nerve discharge has suggested that sympathetic hyperactivity occurs in pregnancy induced hypertension and preeclampsia in comparison with normal pregnancy.ObjectiveTo examine the differences between peripheral sympathetic outputs in pregnancy-induced hypertension and normal pregnancy by directly measuring single impulses of neural discharge.DesignWe compared the sympathetic neural discharge at rest and its reflex responses in subjects with pregnancy-induced hypertension and normal pregnancy and re-examined their progress at least 6 weekspost partum. The patients with pregnancy-induced hypertension were hospital in-patients for whom the diagnosis could be strictly defined and the normally pregnant women were recruited to match the former.MethodsStandard microneurography was performed to quantify single impulses of action potentials, together with the processed multi-unit bursts from fibres innervating the leg muscles. We measured neural discharge with vascular vasoconstrictive properties, heart rate and finger arterial blood pressure at rest and their responses to standard isometric hand-grip exercise and cold pressor tests.ResultsAs expected, patients with pregnancy-induced hypertension (n = 13) had higher levels of finger arterial blood pressure than did women with normal pregnancies (n = 11). The number of single impulses of action potentials (per min and per 100 cardiac beats) in resting patients with pregnancy-induced hypertension was more than three times greater than that in resting women with normal pregnancies, and the number of multi-unit bursts was twofold greater. After delivery of their child, sympathetic activity and heart rate in nine patients decreased, but finger arterial blood pressure decreased in patients with pregnancy-induced hypertension only.ConclusionsFrom results of cross-sectional and longitudinal studies, pregnancy-induced hypertension is associated with a greater resting sympathetic output than that of women with normal pregnancies. Follow-up data after parturition suggest that this hyperactivity is not the only cause of hypertension.J Hypertens16:617–624 © 1998 Lippincott-Raven Publishers.

 

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