Postpartum Assessment of the Renin Angiotensin System in Women with Previous Severe, Early-Onset Preeclampsia

Context: Women with a history of severe preeclampsia are at an increased risk for the development of vascular disease. Objective: We hypothesized that abnormalities in the renin-angiotensin system (RAS) may be a predisposing factor. Design and Setting: Physiological assessments were conducted at an academic center. Participants: Sixteen women with previous severe preeclampsia (PPE) were compared with nine previously pregnant controls (PPC) and 11 never-pregnant controls (NPC). Interventions: Baseline circulating components of the RAS and expression of angiotensin (ANG) II type I (AT1) and type II (AT2) receptors in the skin were assessed along with the response to simulated orthostatic stress using incremental lower-body negative pressure (LBNP: −15, −25, and −40 mm Hg) and a graded ANG II infusion (1 and 3 ng/kg · min). Main Outcome Measures: Response to LBNP and ANG II was evaluated. Results: RAS components were not different between previously pregnant groups, but were decreased compared with NPC subje...