Low-dose aspirin. II. Relationship of angiotensin II pressor responses, circulating eicosanoids, and pregnancy outcome

Charles E L Brown, Norman F. Gant, Kay Cox, Bernard Spitz, Charles R. Rosenfeld, Ronald R. Magness

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Abstract

Forty pregnant women (28 to 32 weeks' gestation) were given low-dose aspirin therapy (81 mg/day) from the time of enrollment until delivery; circulating eicosanoid levels and angiotensin II pressor responses were measured before and after 1 week of aspirin therapy. Subsequent clinical outcome was correlated with these results. All women had significant reductions in serum and plasma thromboxane B2 levels with aspirin treatment (p < 0.01). Eleven women who remained sensitive to the pressor effects of angiotensin II (effective pressor dose < 10 ng/kg/min) after 1 week of low-dose aspirin treatment exhibited significant decreases (p < 0.05) in plasma 6-keto-prostaglandin F (264 ± 119 vs 161 ± 31 pg/ml, mean ± SD) and prostaglandin E2 (476 ± 174 vs 351 ± 112 pg/ml) levels. In contrast, patients who were either nonsensitive (refractory) to angiotensin II (n = 18; ≥ 10 ng/kg/min) before aspirin or became nonsensitive after aspirin administration (n = 11) had no change in either plasma 6-keto-prostaglandin F or prostaglandin E2 concentrations. The occurrence of pregnancy-induced hypertension was 100% in the women who remained angiotensin II sensitive during aspirin therapy as compared with 36% and 39% in the other two groups (χ2 = 16.14; p < 0.001). Thus during low-dose aspirin therapy a failure to develop refractoriness to infused angiotensin II is associated with a nonselective inhibition of eicosanoids and the almost certain development of pregnancy-induced hypertension. These observations may reflect a basic defect in vascular adaptation to pregnancy.

Original languageEnglish (US)
Pages (from-to)1853-1861
Number of pages9
JournalAmerican journal of obstetrics and gynecology
Volume163
Issue number6 PART 1
DOIs
StatePublished - Dec 1990

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Keywords

  • Low-dose apsirin
  • angiotensin II
  • blood pressure control
  • preeclampsia
  • pressor responses
  • prostaglandins

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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