Different Types Of Hypertension Research Articles

Shared and Distinct Cellular and Molecular Landscapes of Cardiac Left Ventricle Injury in Three Models of Hypertension: Insights from Single-nucleus RNA Sequencing

High blood pressure is the leading risk factor of heart diseases, affecting millions of patients who remain hypertensive despite taking three or more anti-hypertensive medications. Understanding the cellular and molecular basis of heart damage at cell type-specific level in different types of hypertension is crucial for developing targeted therapies. In this study, we applied 10x Genomics' single-nucleus RNA sequencing (snRNA-seq) technology to cardiac left ventricle samples from three well-established hypertension models: C57BL/6 mice treated with Ang II, the Dahl salt-sensitive rat, and the spontaneous hypertensive rat, along with their respective controls. Our dataset included 166,489 nuclei from 18 samples across 9 experimental conditions. Our analysis revealed a shared set of cellular and molecular changes across these hypertensive models. For instance, we observed extracellular matrix remodeling in fibroblasts in salt-sensitive and spontaneous hypertension, as indicated by increased collagen production. Endothelial cells showed an increased proportion in all three models, and showed higher levels of injury based on expression patterns of increased proliferation and migration. Both AngII-induced and spontaneous hypertension showed cardiomyocyte dysfunction, affecting cardiac muscle contraction and ATP metabolic process. Notably, impaired ATP generation was a common response in AngII-induced hypertension, involving not only cardiomyocytes but also endothelial cells and fibroblasts. During the progression of salt-sensitive hypertension, a notable increase in inflammation occurred, marked by steadily increasing immune cell infiltration, eventually reaching a 1.5-fold increase in immune cells. T cells were particularly elevated during the high-salt diet and actively engaged in the CD45 signaling network in the late stage of spontaneous hypertension, where an elevated interaction between cardiomyocyte and endothelial cells through vascular endothelial growth factor was observed. In conclusion, the utilization of snRNA-seq identified shared and distinct cellular and molecular changes associated with left ventricular injury in various models of hypertension. NIH grant HL149620. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Medication for hypertension management

Hypertension is a major risk factor for cardiovascular disease, heart failure, vascular dementia and chronic kidney disease, and the management of hypertension combines both lifestyle and pharmacological interventions. Guidelines are available nationally and internationally to support these approaches to managing blood pressure and reducing cardiovascular risk. This article discusses the diagnosis and management of hypertension, along with the role of medication to lower blood pressure. Particular consideration is given to the place for different drug treatments based on their mode of action, specific indications and potential side effects. By the end of this article, readers should be able to review how different types of hypertension are diagnosed; compare national and international guidelines; consider the different types of medication most commonly used in hypertension; and evaluate the mode of action and how this influences indication for use and possible side effects.

Trend of hypertension death and its impact on life expectancy in 6 northwestern provinces of China, 2013-2021

Objective: To analyze the mortality trend of hypertension in Xinjiang Uygur Autonomous Region, Qinghai Province, Shaanxi Province, Gansu Province, Ningxia Hui Autonomous Region and Inner Mongolia Autonomous Region (6 provinces) in northwestern China, from 2013 to 2021, and evaluate the influence of hypertension on people's life expectancy. Methods: Based on national death surveillance data and demographic data in the 6 provinces from 2013 to 2021, the mortality rate, standardized mortality rate, life expectancy, cause eliminated life expectancy (CELE), potential gains in life expectancy (PGLEs) and life loss rate of hypertension were calculated. Software Joinpoint was used to analyze the mortality trends and calculate average annual percentage change (AAPC) and annual percentage change (APC) in hypertension deaths. Results: From 2013 to 2021, the overall standardized mortality rate of hypertension in the 6 provinces showed a downward trend (AAPC=-1.82%, P=0.050). The mortality rate in rural area was always higher than that in urban area, and showed an increasing trend after 2016 (APC=4.74%, P=0.003), and the mortality rate in men was always higher than that in women. The incidence trend of deaths of different types of hypertension were different, and the deaths caused by hypertensive heart disease accounted for the highest proportion (72.69%). In 2021, the life expectancy of the population in the 6 provinces increased by 1.01 years, the CELE increased by 0.93 years, the PGLEs decreased by 0.08 years, and the life loss rate decreased by 0.11% compared with 2013. Conclusions: The overall standardized mortality rate of hypertension showed a decreasing trend in the 6 northwestern provinces from 2013 to 2021, but it showed an increasing trend in rural area after 2016. Prevention of hypertension should be further strengthened in rural area, men and elderly population.

FORMULATION AND IN-VITRO EVALUATION OF NICARDIPINE HYDROCHLORIDE BILAYERED TABLET FOR CONTROLLED RELEASE

The aim of present research work was to prepare and evaluate the controlled release bilayered tablet of Nicardipine HCL to improve its bioavailability for the treatment of hypertension. To minimize critical process parameters, two layer compression method was used for the formulation of Bilayered tablets. The appropriate formulation was achieved successfully with the combination of Polymers MCC, Carbopol 71G and HPMC K100M produced desired release profile for Metoprolol succinate extended release layer. The combination of disintegrating agents that is Sodium starch glycolate and Dicalcium phosphate produced desired release rate for Nicardipine immediate release layer. The results reveal that formulation F7 has met the objective of controlled drug release for over a period of 12 hrs. The formulation F7 ascertained the efficacy of the controlled released Bilayered tablet of Nicardipine and Metoprolol ER tablet in hypertension. This sustained release Bilayered tablet with the combination of Nicardipine and metoprolol can be used in the management of different types of hypertension. The formulation F7 of combination of Nicardipine and metoprolol showed controlled release profile among the other, Hence it was considered as an optimized formulation.

Hypertension as a Risk Factor for Adverse Neonatal and Maternal Outcome

Introduction: During the period of pregnancy, many physical and social activities can become of great risk to the fetal and maternal outcome. Among the many physical ailments that have an effect on maternal and fetal outcome, hypertension and diabetes are the most common cause, and effects. During diabetes, maternal hypertension and gestational diabetes can occur, and can cause great changes to the outcome of pregnancy. The present study was conducted among all hypertension patients to see the different types of hypertension and their incidence rate among pregnant women, and their maternal and fetal outcomes at pregnancy. Methods: This descriptive cross-sectional study was conducted at the Department of Gynecology, Kushtia 250 bed General Hospital, Kushtia, Bangladesh. The study duration was 1 year, from January 2020 to January 2021. During this period, a total of 100 cases of hypertensive pregnancies visiting the study place were admitted following the inclusion and exclusion criteria. Result: Majority of the hypertensive mothers had been between the ages of 21-25 years, while mean birth weight was below normal range among the neonates. Moderate preeclampsia had the highest prevalence among the mothers, and anemia and nulliparity were observed in 67% and 44% respectively as risk factors among the participants. Adverse perinatal outcome had a significantly high prevalence among neonates of preeclampsia groups. Conclusion: The study observed higher incidence of preeclampsia among pregnant women, and adverse perinatal outcomes had significant rise among preeclampsia cases. Anemia was the most common risk factor for hypertension in the present study, followed by Nulliparity. Adverse maternal outcomes did not have a significant association with type of hypertension, but seizure and oliguria were more common among preeclampsia cases.

Why Multitarget Vasodilatory (Endo)cannabinoids Are Not Effective as Antihypertensive Compounds after Chronic Administration: Comparison of Their Effects on Systemic and Pulmonary Hypertension.

Systemic and pulmonary hypertension are multifactorial, high-pressure diseases. The first one is a civilizational condition, and the second one is characterized by a very high mortality rate. Searching for new therapeutic strategies is still an important task. (Endo)cannabinoids, known for their strong vasodilatory properties, have been proposed as possible drugs for different types of hypertension. Unfortunately, our review, in which we summarized all publications found in the PubMed database regarding chronic administration of (endo)cannabinoids in experimental models of systemic and pulmonary hypertension, does not confirm any encouraging suggestions, being based mainly on in vitro and acute in vivo experiments. We considered vasodilator or blood pressure (BP) responses and cardioprotective, anti-oxidative, and the anti-inflammatory effects of particular compounds and their influence on the endocannabinoid system. We found that multitarget (endo)cannabinoids failed to modify higher BP in systemic hypertension since they induced responses leading to decreased and increased BP. In contrast, multitarget cannabidiol and monotarget ligands effectively treated pulmonary and systemic hypertension, respectively. To summarize, based on the available literature, only (endo)cannabinoids with a defined site of action are recommended as potential antihypertensive compounds in systemic hypertension, whereas both mono- and multitarget compounds may be effective in pulmonary hypertension.

Attributing hypertensive life expectancy loss to ambient heat exposure: A multicenter study in eastern China

Ambient high temperature is a worldwide trigger for hypertension events. However, the effects of heat exposure on hypertension and years of life lost (YLL) due to heat remain largely unknown. We conducted a multicenter study in 13 cities in Jiangsu Province, China, to investigate 9727 individuals who died from hypertension during the summer months (May to September) between 2016 and 2017. Meteorological observation data (temperature and rainfall) and air pollutants (fine particulate matter and ozone) were obtained for each decedent by geocoding the residential addresses. A time-stratified case-crossover design was used to quantify the association between heat and different types of hypertension and further explore the modification effect of individual and hospital characteristics. Meanwhile, the YLL associated with heat exposure was estimated. Our results show that summer heat exposure shortens the YLL of hypertensive patients by a total of 14,74 years per month. Of these, 77.9% of YLL was mainly due to hypertensive heart disease. YLL due to heat was pronounced for essential hypertension (5.1 years (95% empirical confidence intervals (eCI): 4.1–5.8)), hypertensive heart and renal disease with heart failure (4.4 years (95% eCI: 0.9–5.9)), and hypertensive heart and renal disease (unspecified, 3.5 years (95% eCI: 1.8–4.5)). Moderate heat was associated with a larger YLL than extreme heat. The distance between hospitals and patients and the number of local first-class hospitals can significantly mitigate the adverse effect of heat exposure on longevity. Besides, unmarried people and those under 65 years of age were potentially susceptible groups, with average reduced YLL of 3.5 and 3.9 years, respectively. Our study reveals that heat exposure increases the mortality risk from many types of hypertension and YLL. In the context of climate change, if effective measures are not taken, hot weather may bring a greater burden of disease to hypertension due to premature death.

Uzunlamasına Kan Basıncı Verilerindeki Değişimleri Tespit Etmek İçin Rassal Orman Temelli Bir İzleme Yöntemi: Retrospektif Bir Çalışma

Objective: High blood pressure is a serious health condition. Patients and clinicians need tools to early detect deviations from normal blood pressure. Adapting modern methods of monitoring to blood pressure monitoring (BPM) has been a favorable solution. This study focuses on adaptation of machine learning to BPM. The daily chrono-biological changes effect blood pressure and may lead to false alarms in an early detection system. We provide an approach that detects changes in blood pressure with limited baseline data. Material and Methods: Our approach uses random forest as an alternative to traditional process monitoring algorithms which test each data point compared to a baseline dataset. In addition, our method converts testing problem into a supervised learning problem using a sliding baseline. We used real data and synthetic data to show the potential of the proposed method for different types of hypertension: sisto-diastolic hypertension, isolated diastolic hypertension and white coat effect. Results: Our observations support that the method can detect various patterns such as sisto-diastolic hypertension, isolated diastolic hypertension and white coat effect successfully. Conclusion: We described the development of a machine learning based monitoring approach to early detect changes in blood pressure. The proposed method (1) requires relatively small baseline data, (2) can be adapted to realtime patient data, and (3) can detect various types of hypertension.

Computational hemodynamics and thermal analysis of laminar blood flow for different types of hypertension

Computational hemodynamics (CHD) is a promising engineering technique that has allowed doctors to learn a lot about patients’ conditions in various diseases such as cardiovascular disease (CVD) and even surgery. In industrialized countries, hypertension is becoming a widespread public health issue, resulting in death in extreme cases. A successful method for investigating hypertension in both diastolic and systolic conditions is to use the finite volume method (FVM) to incorporate velocity and pressure. Due to the use of Magnetic Resonance Image (MRI) and Digital Imaging and Communications in Medicine (DICOM), the 3D geometry has an acceptable accuracy, and the geometry has been created based thereon. The flow of blood is regarded as steady, lamina, incompressible, and non-Newtonian. Herein, all the age groups have their unique effect on the parameters reported, including Nusselt number and dimensionless numbers, e.g., average wall shear stress (AWSS), temperature, and pressure drop. In such a numerical simulation, all the results revealed that the parameters improved by increasing diastolic and systolic blood pressure. Nevertheless, the patient is recommended to see a doctor urgently in case of a hypertensive situation.

The cardiovascular phenotype of childhood hypertension: a cardiac magnetic resonance study

BackgroundThe cardiovascular phenotype is poorly characterized in treated pediatric hypertension. Cardiovascular magnetic resonance imaging (MRI) can be used to better characterize both cardiac and vascular phenotype in children with hypertension.ObjectiveTo use MRI to determine the cardiac and vascular phenotypes of different forms of treated hypertension and compare the results with those of healthy children.Materials and methodsSixty children (15 with chronic renal disease with hypertension, 15 with renovascular hypertension, 15 with essential hypertension and 15 healthy subjects) underwent MRI with noninvasive blood pressure measurements. Cardiovascular parameters measured include systemic vascular resistance, total arterial compliance, left ventricular mass and volumetric data, ejection fraction and myocardial velocity. Between-group comparisons were used to investigate differences in the hypertension types.ResultsRenal hypertension was associated with elevated vascular resistance (P≤0.007) and normal arterial compliance. Conversely, children with essential hypertension had normal resistance but increased compliance (P=0.001). Renovascular hypertension was associated with both increased resistance and compliance (P≤0.03). There was no difference in ventricular volumes, mass or cardiac output between groups. Children with renal hypertension also had lower systolic and diastolic myocardial velocities.ConclusionCardiovascular MRI may identify distinct vascular and cardiac phenotypes in different forms of treated childhood hypertension. Future studies are needed to investigate how this may inform further optimisation of blood pressure treatment in different types of hypertension.

Relevance of microRNA 21 in Different Types of Hypertension.

Hypertension (HTN) is a chronic medical condition that commonly affects the aging population worldwide. The prevalence of HTN is increasing in developing countries and is one of the leading causes of death in older individuals. HTN results from a complex interplay of genetic and environmental factors. Besides, HTN can result in various other health complications such as stroke and chronic kidney diseases, if not treated. Although various studies have explained the underlying mechanisms in the pathogenesis of HTN, limited information is available on their biomarkers. MicroRNAs (miRNAs) are RNA molecules that have been recognized as key regulators for HTN. miR-21 is a common microRNA that is has been reported to be significantly upregulated in HTN individuals. Hence, miR-21 can be a potential therapeutic target for HTN. The number of studies related to miR-21 on hypertension is limited. Therefore, the main thrust of this paper is to provide an overview of the current clinical evidence and significance of miR-21 in HTN.

Changes in the pancreas caused by different types of hypertension.

Hypertension is considered a lifestyle disease. Unfavorable forecasts predict a significant increase in the number of patients suffering from this disorder. Many changes in various organs have been observed as a result of ischemia. An interesting question arises of whether differences between the mechanisms occurring in different types of hypertension could produce different effects in the organs. It is well known that there is a close relationship between hypertension and insulin resistance. On the other hand, insulin resistance is the main cause of type 2 diabetes, which develops in parallel with changes in the pancreas. The pancreas is a very important organ since it produces enzymes crucial for the digestive process, as well as performs an important endocrine function. The work presented here focuses primarily on the latter issue. The authors present an overview of contemporary literature concerning the influence of different types of hypertension on the function of the pancreas.

Nitric Oxide Deficit Drives Intimal Hyperplasia in Mouse Models of Hypertension

To evaluate the impact of different types of hypertension on the development of intimal hyperplasia (IH). Genetic, surgical, and pharmacological models of hypertension were used to compare IH formation in a murine model of carotid artery ligation (CAL). CAL was performed in normotensive WT male mice and in three mouse models of hypertension: (1) L-NAME (Nω-nitro-l-arginine-methyl-ester) treatment for 2 weeks prior to CAL to instate renin-independent hypertension; (2) 2K1C (two kidneys, one clip) surgery 1 week prior to CAL to induce renin-dependent hypertension; (3) Cx40-/- mice, a genetic model of renin-dependent hypertension. Mice were sacrificed prior to CAL or 3, 14, or 28 days post CAL. Data collection included tail blood pressure measurements, and morphometric and histological assessment of the ligated carotids. CAL triggered the formation of a VSMC-rich neointima layer after 14-28 days, which was increased in all hypertensive mice. Despite similarly increased blood pressure, L-NAME treated mice displayed more IH than all other hypertensive groups. In addition, L-NAME induced hypertension triggered more cell proliferation and recruitment of CD45 positive inflammatory cells to the ligated vessel wall compared with Cx40-/- or normotensive WT mice. NO deficiency is a major aspect of vascular inflammation, VSMC proliferation, and IH in hypertensive conditions.

Hypertension and Autonomic Control

Arterial hypertension is considered one of the most important public health problems and had their development, progression and complications associated with the autonomic nervous system (ANS). In this context, the present systematic review aim at gathering recent studies (2003-2013) that addressed the relation between ANS and hypertension, in order to update the knowledge in the last 10 years. Searches were made onMedLine / PubMed, PEDro, SciELO, IBECS, COCHRAINE and LILACS databases using the intersection between the keywords hypertension, autonomic nervous system, sympathetic nervous system , parasympathetic nervous system and heart rate variability”. A total of 17 articles were included and main findings of this review indicating the acute influence of the ANS in different types of hypertension characterized by a reduction of the overall heart rate variability (HRV) and a reduction in the parasympathetic component of ANS evaluated by linear indexes. In addition, the behavior of the sympathetic component could present an increase or a reduction according to the study design. Thus further studies to assess the influence of chronic influence of ANS on hypertension as well as investigations by nonlinear HRV indexes are needed.

Nurse prescribing for the management of hypertension

This article focuses on the importance of making a correct diagnosis of hypertension in line with National Institute for Health and Care Excellence guidance. The evidence-based approach to managing hypertension is discussed with reference to pharmacological treatments and lifestyle interventions. It is important that nurses know how to correctly measure blood pressure, particularly as ambulatory and home blood pressure monitoring should provide the basis for the diagnosis and decisions relating to patient management of hypertension. The different types of hypertension (stage 1, stage 2, severe and white coat hypertension) are described. The evidence-based approach to managing hypertension is then discussed with reference to pharmacological treatments and lifestyle interventions. This discussion is accompanied by the ACD algorithm highlighting the first four steps in hypertension treatment.

Endothelium-specific sepiapterin reductase deficiency in DOCA-salt hypertension

The endothelial nitric oxide synthase (eNOS) requires tetrahydrobiopterin (H(4)B) as a cofactor and, in its absence, produces superoxide (O(2)(·-)) rather than nitric oxide (NO(·)), a condition referred to as eNOS uncoupling. DOCA-salt-induced hypertension is associated with H(4)B oxidation and uncoupling of eNOS. The present study investigated whether administration of sepiapterin or H(4)B recouples eNOS in DOCA-salt hypertension. Bioavailable NO(·) detected by electron spin resonance was markedly reduced in aortas of DOCA-salt hypertensive mice. Preincubation with sepiapterin (10 μmol/l for 30 min) failed to improve NO(·) bioavailability in hypertensive aortas while it augmented NO(·) production from control vessels, implicating a hypertension-associated deficiency in sepiapterin reductase (SPR), the rate-limiting enzyme for sepiapterin conversion to H(4)B. Indeed, a decreased SPR expression was observed in aortic endothelial cells, but not in endothelium-denuded aortic remains, implicating an endothelium-specific SPR deficiency. Administration of hypertensive aortas with H(4)B (10 μmol/l, 30 min) partially restored vascular NO(·) production. Combined administration of H(4)B and the NADPH oxidase inhibitor apocynin (100 μmol/l, 30 min) fully restored NO(·) bioavailability while reducing O(2)(·-) production. In angiotensin II-induced hypertension, however, aortic endothelial SPR expression was not affected. In summary, administration of sepiapterin is not effective in recoupling eNOS in DOCA-salt hypertension, due to an endothelium-specific loss in SPR, whereas coadministration of H(4)B and apocynin is highly efficient in recoupling eNOS. This is consistent with our previous observations that in angiotensin II hypertension, endothelial deficiency in dihydrofolate reductase is alternatively responsible for uncoupling of eNOS. Taken together, these data indicate that strategies specifically targeting at different H(4)B metabolic enzymes might be necessary in restoring eNOS function in different types of hypertension.

Impact of different types of hypertension on arteriosclerosis in diabetic patients

Objective To investigate the impact of different types of hypertension on arteriosclerosis in type 2 diabetic patients using a non-invasive vascular screening device.Methods 173 diabetic patients were assigned to 3 groups：group A(without hypertension,n=55),group B(systolic hypertension,n=60)and group C(both systolic and diastolic hypertension,n=58).Arterial stiffness was measured by brachial-ankle pulse wave velocity(baPWV)and ankle-brachial index(ABI).Body mass index(BMI),Glycosylated hemoglobin(HbA1c),high-sensitivity C-reactive protein(hs-CRP),plasma lipid levels were measured.Results baPWV in group B and group C was significantly higher than that in group A(P<0.05),while ABI in group B and group C was lower than that in group A(P<0.05).baPWV in group B was highest among 3 groups(P<0.05),while ABI in group B was lowest(P<0.05).Pulse pressure in group B was highest among 3 groups(P<0.05).Correlation analysis after adjustment for age and sex showed that course of hypertension,course of diabetes,LDL-C,HbA1c,pulse pressure and hs-CRP were significantly related to baPWV(P<0.05 for all).A stepwise multiple regressive analysis demonstrated that age,LDL-C,HbA1c,pulse pressure and hs-CRP were predisposed factors for higher baPWV(P<0.05 for all).Logistic regressive analysis displayed that HbA1c and hs-CRP were risk factors for lower ABI(P<0.05 for all).Conclusions Hypertension aggravates arteriosclerosis in type 2 diabetic patients.Reasonable and long-term administration of hyperglycaemia,hypertension and hyperlipemia would contribute to ameliorate arteriosclerosis in type 2 diabetic patients.

Effects of Blood Pressure Lowering on Major Vascular Events Among Patients With Isolated Diastolic Hypertension

Despite clear evidence that blood pressure (BP) lowering is effective for prevention of cardiovascular events among patients with isolated systolic hypertension and systolic-diastolic hypertension, there is ongoing uncertainty about its effects in those with isolated diastolic hypertension. The objective of the present analysis is to determine whether BP lowering provides benefits to patients with isolated diastolic hypertension. Patients with cerebrovascular disease and hypertension at baseline (n=4283) were randomly assigned to either active treatment (perindopril in all participants plus indapamide for those with neither an indication for nor a contraindication to a diuretic) or matching placebo(s). The primary outcome was total major vascular events. There were 1923 patients with isolated systolic hypertension (systolic BP ≥ 140 mm Hg and diastolic BP < 90 mm Hg), 315 with isolated diastolic hypertension (systolic BP <140 mm Hg and diastolic BP ≥ 90 mm Hg), and 2045 with systolic-diastolic hypertension (systolic BP ≥ 140 mm Hg and diastolic BP ≥ 90 mm Hg) at baseline. Active treatment reduced the relative risk of major vascular events by 27% (95% CI, 10% to 41%) among patients with isolated systolic hypertension, by 28% (-29% to 60%) among those with isolated diastolic hypertension, and by 32% (17% to 45%) among those with systolic-diastolic hypertension. There was no evidence of differences in the magnitude of the effects of treatment among different types of hypertension (P homogeneity=0.89). BP lowering is likely to provide a similar level of protection against major vascular events for patients with isolated diastolic hypertension as for those with isolated systolic hypertension and systolic-diastolic hypertension. Clinical Trial Registration Information- This trial was not registered because patients were enrolled before July 1, 2005.

Birth weight and infant growth after a hypertensive pregnancy. Is the gestation or the disease more important?

Hypertension affects up to 10% of all pregnancies. Small babies are up to 1.6 times more likely in a hypertensive pregnancy (Allen, Joseph et al. 2004).Materials & methodsNottingham City Hospital...

Hemodynamic and neurohumoral profile in patients with different types of hypertension in pregnancy

Hypertension in pregnancy is a frequent disorder that includes a spectrum of conditions. We aimed at comparatively evaluating the hemodynamic, echocardiographic and biohumoral profile of a sample of pregnant Caucasian women with different form of pregnancy-related hypertension. We enrolled 39 non-hypertensive pregnant women (NP), 26 with Chronic HBP in pregnancy (CH), 24 with gestational hypertension (G-PIH), and 33 with pre-eclampsia. We recorded and compared blood pressure (BP), echocardiographic parameters, resting plasma renin activity (PRA) and plasma aldosterone (PA), Plasma levels of atrial (ANP) and brain natriuretic peptide (BNP). PE patients had a significantly higher BP than either G-PIH or NP patients. PE patients had also significantly lower cardiac output than NP, G-PIH and CH. In comparison to NP patients, the total peripheral vascular resistance was 61% higher in PE women and 38% higher in CH patients. All echographic parameters were significantly more altered in PE patients when compared with NP, in respect to any other form of hypertension. Either ANP (+35%) and BNP (+40%) were significantly higher in PE patients than in controls. The PRA was reduced in PE and CH patients when compared either with NP (-38 and -35%, respectively) or G-PIH (-47 and -43%, respectively). On the basis of our data, we can conclude that PE is the gestation associated hypertension with the largest anatomical, functional and biohumoral involvement, and so it has to be involved in a more intensive monitoring and evaluation.