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Aldosterone and renin concentrations were abnormally elevated in a cohort of normotensive pregnant women

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Abstract

Background

During pregnancy, the renin–angiotensin–aldosterone system (RAAS) undergoes major changes to preserve normal blood pressure (BP) and placental blood flow and to ensure a good pregnancy outcome. Abnormal aldosterone–renin metabolism is a risk factor for arterial hypertension and cardiovascular risk, but its association with pathological conditions in pregnancy remains unknown. Moreover, potential biomarkers associated with these pathological conditions should be identified.

Aim

To study a cohort of normotensive pregnant women according to their serum aldosterone and plasma renin levels and assay their small extracellular vesicles (sEVs) and a specific protein cargo (LCN2, AT1R).

Methods

A cohort of 54 normotensive pregnant women at term gestation was included. We determined the BP, serum aldosterone, and plasma renin concentrations. In a subgroup, we isolated their plasma sEVs and semiquantitated two EV proteins (AT1R and LCN2).

Results

We set a normal range of aldosterone and renin based on the interquartile range. We identified 5/54 (9%) pregnant women with elevated aldosterone and low renin levels and 5/54 (9%) other pregnant women with low aldosterone and elevated renin levels. No differences were found in sEV-LCN2 or sEV-AT1R.

Conclusion

We found that 18% of normotensive pregnant women had either high aldosterone or high renin levels, suggesting a subclinical status similar to primary aldosteronism or hyperreninemia, respectively. Both could evolve to pathological conditions by affecting the maternal vascular and renal physiology and further the BP. sEVs and their specific cargo should be further studied to clarify their role as potential biomarkers of RAAS alterations in pregnant women.

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Funding

This study was supported by the following grants: ANID/CONICYT-FONDECYT 1160695, 1190250, and 1212006; FONDECYT-POSTDOCTORAL 3200646; CONICYT-FONDEQUIP EQM150023; ANID–Millennium Science Initiative Program—IMII P09/016-F, ICN09_016; CORFO BMRC-13CTI-21526-P1; and SOCHED 2019-09 and CETREN-UC.

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Author notes

  1. These authors contributed equally: Valentina Pastén, Cristian A. Carvajal

Authors and Affiliations

  1. Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    Valentina Pastén, Alejandra Tapia-Castillo, Carlos E. Fardella & Cristian A. Carvajal

  2. Millennium Institute on Immunology and Immunotherapy (IMII-ICM), Santiago, Chile

    Alejandra Tapia-Castillo, Carlos E. Fardella & Cristian A. Carvajal

  3. Centro Traslacional de Endocrinología UC (CETREN), Santiago, Chile

    Alejandra Tapia-Castillo, Carlos E. Fardella & Cristian A. Carvajal

  4. Division of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    Andrea Leiva

  5. School of Medical Technology, Health Sciences Faculty, Universidad San Sebastian, Santiago, Chile

    Andrea Leiva

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  1. Valentina Pastén
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  2. Alejandra Tapia-Castillo
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  3. Carlos E. Fardella
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  4. Andrea Leiva
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Contributions

V.P., A.L., C.A.C., C.E.F. and A.T.-C. designed the study, collected, analyzed, interpreted the patients data, and wrote the first draft of the manuscript. All authors contributed to the discussion, reviewed the manuscript, and approved the final version.

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Correspondence to Andrea Leiva or Cristian A. Carvajal.

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Pastén, V., Tapia-Castillo, A., Fardella, C.E. et al. Aldosterone and renin concentrations were abnormally elevated in a cohort of normotensive pregnant women. Endocrine 75, 899–906 (2022). https://doi.org/10.1007/s12020-021-02938-0

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