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Smooth Muscle Mineralocorticoid Receptor Promotes Hypertension After Preeclampsia

2023; Lippincott Williams & Wilkins; Volume: 132; Issue: 6 Linguagem: Inglês

10.1161/circresaha.122.321228

1524-4571

Lauren A. Biwer, Qing Lu, Jaime Ibarrola, Alec Stepanian, Joshua J. Man, Brigett Carvajal, Nicholas D. Camarda, Zsuzsanna K. Zsengellér, Geraldine Skurnik, Ellen W. Seely, S. Ananth Karumanchi, Iris Z. Jaffe,

Hormonal Regulation and Hypertension

Preeclampsia is a syndrome of high blood pressure (BP) with end organ damage in late pregnancy that is associated with high circulating soluble VEGF receptor (sFlt1 [soluble Fms-like tyrosine kinase 1]). Women exposed to preeclampsia have a substantially increased risk of hypertension after pregnancy, but the mechanism remains unknown, leaving a missed interventional opportunity. After preeclampsia, women have enhanced sensitivity to hypertensive stress. Since smooth muscle cell mineralocorticoid receptors (SMC-MR) are activated by hypertensive stimuli, we hypothesized that high sFlt1 exposure in pregnancy induces a postpartum state of enhanced SMC-MR responsiveness.