ICHIHARA Atsuhiro    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor and Division head
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Soluble (pro)renin receptor and blood pressure during pregnancy: a prospective cohort study.
Journal	Formal name：Hypertension Abbreviation：Hypertension ISSN code：1524-4563(Electronic)0194-911X(Linking)
Volume, Issue, Page	60(5),pp.1250-6
Author and coauthor	WATANABE Noriyoshi†, BOKUDA Kanako, FUJIWARA Takeo, SUZUKI Tomo, MITO Asako, MORIMOTO Satoshi, Seung Chik Jwa , EGAWA Makiko, ARAI Yoshie, SUZUKI Fumiaki, SAGO Haruhiko, ICHIHARA Atsuhiro
Publication date	2012/11
Summary	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.
DOI	10.1161/HYPERTENSIONAHA.112.197418
Document No.	23045457