Aim: To evaluate postpartum blood pressure (BP) and renal function across the following subtypes of hypertensive disorders of pregnancy (HDP): gestational hypertension (GH), preeclampsia (PE) or superimposed preeclampsia (SPE), and chronic hypertension (CH). Methods: Dara from two studies in the Japan Birth Cohort Consortium were used: Tohoku Medical Megabank Project Birth and Three-Generation (TMM BirThree) Cohort Study and the Babies and their parents' longitudinal Observation in Suzuki memorial Hospital in Intrauterine period (BOSHI) study. The TMM BirThree Cohort Study measured casual BP in 2,948 women and blood urea nitrogen (BUN) and creatinine (Cr) levels in 2,937 women (7.1 +/- 1.0 years postpartum). The BOSHI study assessed home BP values obtained from 280 women and BUN and Cr levels measured in 221 women (8.0 +/- 0.7 years). BP, BUN, and Cr values were analyzed using analysis of covariance. Results: Women with CH exhibited higher casual and home systolic and diastolic BP values than women with normotension, GH, and PE/SPE. In both cohorts, women with PE/SPE maintained higher BUN and Cr levels than those with normotension, GH, or CH. Conclusions: Overall, pregnant women with CH exhibited higher casual and home BP values than those with other HDP subtypes, while those with PE/SPE showed elevated BUN and Cr levels.
Introduction: Orexin is a hypothalamic neuropeptide involved in the regulation of appetite, arousal, blood pressure, and vascular function. Psychological stress has been reported to activate the orexin system and influence cardiovascular regulation. Hypertensive disorders of pregnancy (HDP) are characterized by increased psychological stress, oxidative stress, and vascular endothelial dysfunction, making HDP a suitable clinical condition to investigate potential interactions among these factors during pregnancy. However, the relationship between orexin, psychological stress, and pregnancy-related vascular dysfunction remains unclear. This prospective observational study investigated whether plasma orexin levels are associated with psychological stress, oxidative stress, and vascular endothelial dysfunction in women with HDP. Methods: Twenty-one pregnant women diagnosed with HDP after 20 weeks of gestation and ten normotensive pregnant women were enrolled. Plasma orexin levels, psychological stress assessed by the Perceived Stress Scale (PSS), vascular oxidative stress measured using diacron-reactive oxygen metabolites (d-ROMs), and endothelial function evaluated by flow-mediated dilation (FMD) of the brachial artery were assessed. Results: Plasma orexin levels were significantly higher in the HDP group than in the Control group (median [interquartile range]: 3.26 [3.11-3.72] vs. 2.86 [2.21-2.95], P= 0.002). Plasma orexin levels were inversely correlated with FMD (R=- 0.494, P= 0.037) and positively correlated with d-ROM levels (R = 0.567, P= 0.009). Conclusions: Plasma orexin levels are elevated in pregnant women with HDP and are associated with psychological stress and vascular oxidative stress, suggesting a potential role for orexin in vascular endothelial dysfunction in HDP.
