Abstract 4142557: Relationship between levels of nitric oxide (NO) concentration and flow-mediated vasodilatation test (FMD) in endothelial dysfunction development in overweight pregnant women with chronic hypertension.

Background: In Central Asia, hypertension accounts for 14.5% of all maternal deathsThe problem of assessing endothelial dysfunction in women with hypertensive disorders during pregnancy are one of the early predictors of cardiovascular events. Objective: to determine the relationship between endothelial dysfunction and levels of nitric oxide (NO) concentration and flow-mediated vasodilatation (FMD) in overweight pregnant women with CHT. Methods: The study included 55 pregnant women of the I-II gestation period, divided into 2 groups. First group (n=34) included healthy pregnant women (healthy group). Second group (n=24) consisted of pregnant women with chronic hypertension/CHT. A physical examination was performed, heart rate was assessed, blood pressure was measured according to Korotkov method, body mass index (BMI) was calculated. Endothelial function was analyzed using a flow-mediated dilation (FMD) test by using ultrasound system Simens Acuson X700 and the level of nitric oxide (NO) concentration. NO level, which was determined by amount the main stable metabolites NO2 - and NO3 - were assessed by P.P. Golikov method. Results are presented as mean±SD. Statistical processing was carried out using the Statistica 13.0 program. P < 0.05 was considered statistically significant. Results: It was revealed that there was no significant difference in the age of women (27±3.4 in 1 group vs 29±4.5 in 2 group, P = 0.0658) and number of pregnancies between groups (3.3±1.2 in 1 group vs 3.2±1.6 in 2 group, P = 0.7920). The average level of blood pressure in the group with CHT amounted to systolic blood pressure (SBP) of 153.83±16.43 mmHg. vs 102.72±10.42 mmHg in group 1 (P <0.0001), according to diastolic blood pressure (DBP) 96.16±7.62 mmHg. vs 64.77±5.9 mmHg. in 1st group (P <0.0001). Heart rate in group 1 was 89.8±12.2 beats/min and in group 2 93.5±13.8 beats/min (P=0.22). At the same time, 23 pregnant women (95.8%) with CHT were overweight, of which 15(62.5%) were women with obesity of the I and II degree. In the healthy group, there were only 7 women (16%) who were overweight, and no obese women were identified. The mean value of FMD for 1 group was 6.2±3.5% vs 4.82±1.02 (P <0.0001), meanwhile NO – 8.8±0.281 µmol/l in group 1 vs NO – 13.7±0.517 µmol\l (P <0.0001). Conclusion: In conclusion, FMD measured by using an ultrasound system and determination of the blood serum NO level is associated with early diastolic dysfunction in overweight pregnant women with CHT.