Thromboxane A2 synthesis in pregnancy-induced hypertension.
Urinary excretion of thromboxane B2 metabolites as markers of thromboxane A2 synthesis was measured in eight patients with moderate to severe pregnancy-induced hypertension and in six normotensive pregnant women at term. Excretion of both 2,3-dinor-TxB2 (median 3919, range 683-16,680 pg/mg creatinine) and 11-dehydro-TxB2 (median 10,187, range 434-57,203 pg/mg creatinine) was significantly higher in the patients with pregnancy-induced hypertension than in the normotensive pregnant group (927[273-1343] and 774[500-2760] pg/mg creatinine, respectively). Thromboxane metabolite excretion correlated with mean arterial blood pressure, plasma lactate dehydrogenase, and platelet count which are indices of the severity of pregnancy-induced hypertension. Excretion of both metabolites fell rapidly post partum in parallel with resolution of clinical signs. Thus, increased thromboxane A2 biosynthesis correlates with disease severity and may have a pathogenetic role in pregnancy-induced hypertension. These findings provide a rationale for the use of aspirin in the treatment as well as in the prevention of this disorder.
Fitzgerald
D J
DJ
Division of Clinical Pharmacology, Vanderbilt University, Nashville, Tennessee 37232.
Rocki
W
W
Murray
R
R
Mayo
G
G
FitzGerald
G A
GA
D000293:Adolescent; D000328:Adult; D001241:Aspirin / Q000627:therapeutic use; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000378:metabolism* / Q000517:prevention & control / Q000652:urine; D015539:Platelet Activation / Q000187:drug effects / Q000502:physiology; D010976:Platelet Count / Q000187:drug effects; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood / Q000378:metabolism* / Q000517:prevention & control / Q000652:urine; D012720:Severity of Illness Index; D013928:Thromboxane A2 / Q000096:biosynthesis*; D013929:Thromboxane B2 / Q000031:analogs & derivatives / Q000652:urine
D013929:Thromboxane B2; D013928:Thromboxane A2; C028965:2,3-dinor-thromboxane B2; C049235:11-dehydro-thromboxane B2; D001241:Aspirin