title: Soluble (pro)renin receptor and blood pressure during pregnancy: a prospective cohort study.
abstract: The renin-angiotensin system is believed to influence blood pressure (BP) during pregnancy, but the associations between BP during pregnancy and the soluble form of the (pro)renin receptor (s[P]RR), a new component of the tissue renin-angiotensin system, remain undetermined. In this prospective cohort study of 437 pregnant women with normal BP (systolic <140 mm Hg and diastolic <90 mm Hg) during early pregnancy (<16 weeks of gestation) regression analysis was performed to examine the associations between plasma s(P)RR concentrations and BP in 3 gestational stages (20-24, 28-32, and 36-40 weeks of gestation) and logistic regression analysis to evaluate the incidence of preeclampsia. Plasma s(P)RR concentrations at early, middle (16-28 weeks), and late pregnancy (>28 weeks) and at delivery averaged 29.7 ± 10.0, 31.3 ± 12.0, 39.2 ± 8.9, and 40.4 ± 10.2 ng/mL (mean ± SD), respectively. A 1-ng/mL increase in plasma s(P)RR concentration in early pregnancy predicted systolic/diastolic BP elevation in the later 3 gestational stages: 0.11 (95% CI, 0.014-0.20)/0.093 (0.027-0.16) mm Hg for 20 to 24 weeks, 0.11 (0.029-0.19)/0.088 (0.027-0.15) mm Hg for 28 to 32 weeks, and 0.16 (0.058-0.26)/0.12 (0.043-0.19]) mm Hg for 36 to 40 weeks, respectively. Plasma s(P)RR concentrations in middle and late pregnancy were not associated with BP. Adjusted models revealed that women with plasma s(P)RR concentrations above the 75th percentile at delivery had a significantly increased risk of preeclampsia (odds ratio, 22.5 [95% CI, 1.8-279.9]). In conclusion, high circulating levels of s(P)RR at early pregnancy predicted a subsequent elevation in BP, and high concentrations at delivery were significantly associated with preeclampsia.
authors.affiliation: Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Shinju, Tokyo 162-8666, Japan.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Watanabe
authors.forename: Kanako
authors.initials: K
authors.lastname: Bokuda
authors.forename: Takeo
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Tomo
authors.initials: T
authors.lastname: Suzuki
authors.forename: Asako
authors.initials: A
authors.lastname: Mito
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morimoto
authors.forename: Seung Chik
authors.initials: SC
authors.lastname: Jwa
authors.forename: Makiko
authors.initials: M
authors.lastname: Egawa
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Arai
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Suzuki
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sago
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Ichihara
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology*; D011247:Pregnancy; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D011956:Receptors, Cell Surface / Q000097:blood*; D012044:Regression Analysis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D025262:Vacuolar Proton-Translocating ATPases / Q000097:blood*; D055815:Young Adult; D000093342:Prorenin Receptor
chemical_list: D011498:Protein Precursors; D011956:Receptors, Cell Surface; D025262:Vacuolar Proton-Translocating ATPases; C458319:ATP6AP2 protein, human; D000093342:Prorenin Receptor