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CC BY-NC-ND 4.0 · Exp Clin Endocrinol Diabetes 2023; 131(04): 222-227
DOI: 10.1055/a-2025-0510
Article

Renin, Aldosterone, and Cortisol in Pregnancy-Induced Hypertension

Krzysztof C Lewandowski
1   Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland
2   Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
,
Monika Tadros-Zins
3   Department of Obstetrics and Gynecology, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
,
Wojciech Horzelski
4   Department of Mathematics and Computer Science, University of Lodz, Lodz, Poland
,
Michał Krekora
3   Department of Obstetrics and Gynecology, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
5   Department of Gynaecology and Obstetrics, 2nd Chair of Gynaecology and Obstetrics, Medical University of Lodz, Lodz, Poland
,
Andrzej Lewinski
1   Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland
2   Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
› Author Affiliations Funding This study was financially supported by statutory funds from the Medical University of Lodz, Lodz, Poland (503/1–107–03/503–11– 001–19–00).
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Abstract

Introduction We aimed to assess renin, aldosterone, and cortisol in the early stages of pregnancy-induced hypertension (PIH), i. e., at the time of diagnosis.

Methods During the postural test, we measured aldosterone, renin [Liason DiaSorin Inc. (Italy)], as well as cortisol, sodium, potassium, and 24-h urinary sodium and potassium excretion in 62 women with newly diagnosed PIH, 70 healthy women during the 3rd trimester of pregnancy, and in 22 healthy non-pregnant women.

Results In all groups, there was a significant increase in aldosterone and renin in upright versus supine posture (p<0.01). Both supine and upright aldosterone concentrations were higher in healthy pregnant women than in women with PIH and the lowest in healthy not-pregnant [supine (median±intequartile range): 25.04±18.4 ng/dL, 18.03±12.58 ng/dL, and 7.48±4.78 ng/dL, p<0.001, upright: 31.60±21.32 ng/dL, 25.11±13.15 ng/dL, and 12.4±12.4 ng/dL, p<0.001, for healthy pregnant, pregnant with PIH, and non-pregnant, respectively]. Supine renin concentrations were higher only in healthy pregnant (p<0.001), while in the upright position, there was a difference only between healthy pregnant and women with PIH (p=0.002). Both in supine and upright positions, there was no difference in the aldosterone-to-renin ratio between healthy pregnant women and women with PIH, though, in both groups, the ratio was higher than in non-pregnant women (p<0.001). Morning cortisol concentrations and 24-h urinary sodium excretion were lower in women with PIH than in healthy pregnant (p<0.001, p=0.002, respectively).

Conclusion Hyperaldosteronism is not involved in the etiology of PIH. In PIH, there is also a tendency towards lower sodium excretion and lower morning cortisol concentrations.

Key words

pregnancy-induced hypertension - gestational hypertension - cortisol - aldosterone-to-renin ratio - SUSPPUP ratio


Publication History

Received: 24 June 2022
Received: 19 September 2022

Accepted: 09 November 2022

Article published online:
20 February 2023

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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