Prediction of pregnancy-induced hypertensive disorders by angiotensin II sensitivity and supine pressor test.
An angiotensin II sensitivity test and a supine pressor test were done consecutively at 28 weeks gestation in 90 healthy, normotensive nulliparous women. None of the supine pressor tests was positive, applying the predefined threshold of a rise of 20 mmHg in diastolic blood pressure after rolling over; nine tests were positive using a corrected 9 mmHg cut-off level. Ten women had a positive angiotensin sensitivity test using a threshold of the effective pressor dose of 8 ng/kg/min; 22 women were positive using an effective pressor dose of less than or equal to 10 ng/kg/min. Later in pregnancy 12 women (13%) developed pregnancy-induced hypertensive disease (PIH). The specificity of both tests of predicting the development of PIH was about 90%. The sensitivity of the angiotensin sensitivity test at the 10 ng/kg/min level was 92%. Because of its low sensitivity of 25% the supine pressor test appears to have no value for the prediction of PIH. There was a significant positive association between angiotensin II refractoriness and birthweight.
Dekker
G A
GA
Department of Obstetrics and Gynaecology, Erasmus University Medical School, Rotterdam, The Netherlands.
Makovitz
J W
JW
Wallenburg
H C
HC
D000328:Adult; D000804:Angiotensin II; D001724:Birth Weight; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D007231:Infant, Newborn; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013484:Supination
D000804:Angiotensin II