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A number of years
ago, this change suggested to a number of folks that perhaps preeclampsia can as an
important target. The idea was that maybe the kind of heterogeneity of preeclampsia,
multiple organ involvement, could have as a common underlying target. There was some
evidence to support that at the time. I mentioned the kidney changes but I also mentioned
that those changes that suggested it were the kind of things you might expect if you
didn’t have adequate endothelial vasodilators. This has been supported by taking vessels
from preeclamptic women, hanging them up in the bath, and they have reduced endothelial
relaxation. So the story can be pretty well supported. It’s been about ten years and now
there’s probably a list that would no longer fit on this slide of markers of endothelial
activation with the disease, with several of these present before the woman is sick. The
concept of endothelial disease is not because of high blood pressure, is not because of
vaso-constriction, but it’s the endothelial changes that bring about the other changes. |