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Therapeutic Advances in Cardiovascular Disease
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Review: Systemic and uteroplacental renin—angiotensin system in normal and pre-eclamptic pregnancies

Lauren Anton

Vascular Research Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA

K. Bridget Brosnihan

Hypertension and Vascular Research Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA, bbrosnih{at}wfubmc.edu

Pregnancy is characterized by an increase in many of the different components of the circulating renin—angiotensin system (RAS). However, the physiological mechanisms of stimulated RAS activity during pregnancy are unknown. Even less understood is how this system may be altered in pre-eclampsia, a hypertensive disorder of pregnancy. Additional studies have shown the presence of a local tissue specific RAS in the uteroplacental unit of normal and pre-eclamptic pregnancies. Differences in normal pregnant and pre-eclamptic RAS component regulation may provide insight into the mechanisms responsible for the clinical pathological features of pre-eclampsia. Specifically, this review summarizes the key findings in the circulating and uteroplacental RAS in normal and pre-eclamptic pregnancies.

Key Words: pregnancy • pre-eclampsia • placenta • uterus • renin—angiotensin system • angiotensin II • angiotensin-(1-7)

Therapeutic Advances in Cardiovascular Disease, Vol. 2, No. 5, 349-362 (2008)
DOI: 10.1177/1753944708094529
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