Journal of Hypertension: Open Access

The relationship between pregnancy hypertension and later life hypertension is explained by long-term impacts of environmental oxidants on the vascular endothelium. These impacts may precede the onset of the disease as a primary defect and may participate in the pathogenesis of hypertension itself. Continuous exposure to strong exogenous oxidants such as NOx (NO and NO 2 ) reversibly oxidizes oxyhemoglobin (Fe 2+ ) to methemoglobin (Fe 3+ ), and irreversible methemoglobinemia can arise because of disruption of the oxidant/antioxidant balance supported by SO 2 metabolites, as inhibitors of antioxidants, and by synergistic degradation of antioxidant thiols . Methemoglobin by itself and from heme, redox-active ferric iron as product of methemoglobin catabolism, have prooxidant properties and cause important structural and functional changes in the vascular endothelium such as growth arrest, senescence, morphological alterations and cell apoptosis. In 1975, an epidemiological study among 204 pregnant women in Labin (Croatia) identified 30 (14.7%) cases of preeclampsia and 25 (12.3%) cases of hypertension in pregnancy. Ten years later, we found a significant number of hypertension cases (N=5; P=0.0027), and among them, we found a significant number of pregnancy-induced hypertension cases (N=3; P=0.0003) and a significant number of psychoneurotic disturbances (P=0.0190), but these conditions were not found in the normotensive women ten years after giving birth (P = 0.1161). Our original findings confirm that hypertension in pregnancy is not a transient impairment but instead is an extension of the effects of exogenously induced oxidative stress on the structure and function of the vascular endothelial, and indicate delayed effects plausibly manifesting as hypertension in later life.

Objective:It is well known that cilnidipine, which is a L/N-type calcium channel blocker (CCB), has Angiotensin (Ang) II lowering effects that result in organ protective effects compared to L-type CCBs. However, a recent study indicated that angiotensin-converting enzyme (ACE) 2, which is expressed in the heart and kidney, metabolizes Ang II to Ang-(1-7), which is a peptide that has organ-protective effects. In this study, we compared the effects of the L-/N-type CCB cilnidipine and the L-type CCB amlodipine on plasma Ang peptides in a rat hypertensive model.

Methods:Eight-week-old Sprague-Dawley rats were administered a chronic infusion of Ang II through an osmotic mini-pump, along with vehicle, cilnidipine, or amlodipine for 28 days, and the plasma renin-angiotensin-aldosterone system (RAAS) levels were examined.

Results:Cilnidipine and amlodipine exerted equivalent antihypertensive effects. As for Ang peptides, amlodipine induced increases in Ang I levels and decreases in Ang-(1-7)/Ang I ratios. However, the cilnidipine group showed significantly higher Ang-(1-7)/Ang II ratios than the control group. As for gene expression, amlodipine significantly decreased the ratio of ACE2/ACE. Moreover, only cilnidipine treatment resulted in a significant reduction in cardiac fibrosis.

Conclusions:The results of the present study demonstrate that the L-/N-type CCB cilnidipine changed the balance between Ang-(1-7) and Ang II and increased the proportion of Ang-(1-7). Taken together, these results suggest that the suppressing the expansion of the area of cardiac fibrosis of cilnidipine is due to increases in the activity of the ACE2-Ang-(1-7) arm.

Body balance data was collected using an electronic baropodometer with a modular platform by Physical Support Italy, in the Electromyography and Posture Biomechanics Laboratory of the School of Physical Education, University of Campinas (Unicamp). The following three groups were studied: group 01, comprised of 15 male hypertensive subjects who take antihypertensive medication; group 02, comprised of 16 male hypertensive subjects; and group 03, comprised of 14 non-hypertensive subjects. The average age of the participants was 52.7 years. The experimental part of the study was conducted under two conditions: bipodalic and monopodalicic, both static. In both conditions, the subjects were barefoot and performed the test first with eyes open, then with eyes closed. In both cases, the equipment was calibrated to 05 seconds for the procedures. Swaying along axes X and Y was recorded in centimeters.Results: Statistical analysis used analysis of variance, two-factor ANOVA without replication p<0.05. The results were significant for the group with hypertensive and hypertensive medication for bipodalic posture. There was no significant difference in variables between the bipodalic posture open and closed eyes. There was significant difference in the posture monopodalic right foot to the hypertensive group on drugs in the X and Y axes eyes closed and the hypertensive group in the X axis right foot eyes closed. The results were also significant for posture monopodalic left foot to the hypertensive group with hypertensive medication and X-axis eyes open and eyes closed. There was no significant difference between open and closed eyes. The differences were always in relation to the axes X and Y. Conclusion: The antihypertensive medication 30 minutes after being ingested associated with high blood pressure (group 01) and only high levels of blood pressure (group 02) change can cause the body balance the risk of falls in people.