[Gestational arterial hypertension. Mechanisms of formation. Treatment with normodipin].

Aim: To study endothelium-dependent vasodilatation (EDVD), plasma endothelin 1,2 (ET-1,2) contents and urinary NO metabolites in normal pregnancy and various kinds of gestoses with evaluation of normodipine effects on blood pressure and EDVD.
Material and Methods: 59 primigravidas 18-32 years of age (pregnancy terms 34-39 weeks) were divided into three groups. Group 1 consisted of 23 women with arterial hypertension treated with normodipine in 11 of them. In group 2 sixteen pregnant women had edema and group 3 consisted of 20 women with physiological pregnancy. 12 non-pregnant women comprised a control group.
Results: In normal pregnancy ET-1,2 content was low while urine NO metabolites levels were high. This contributes to maintaining adequate reaction of the brachial artery in response to the "shiftstress". In women with edema the brachial artery response to short-term occlusion was decreased. In women with both high blood pressure and edema had vascular response paradoxically spastic with a two-fold decrease in blood flow rate, high plasma ET-1.2 contents and low urine NO metabolites levels. Normodipine in gestational arterial hypertension normalizes both blood pressure and EDVD.
Conclusion: Endothelial dysfunction is an important factor predisposing to development of arterial hypertension. Monotherapy with normodipine (5 mg/day in a single daily dose) during 3 weeks is effective in controlling gestational hypertension.