Hypertension in pregnancy - A manifestation of the insulin resistance syndrome?

Pregnancy-induced hypertension (PIH), which includes both gestational hyper tension and preeclampsia, is a common and morbid pregnancy complication for which the pathogenesis remains unclear. Emerging evidence suggests that in sulin resistance, which has been linked to essential hypertension, may play a role in PIH. Conditions associated with increased insulin resistance, in cluding gestational diabetes, polycystic ovary syndrome, and obesity, may p redispose to hypertensive pregnancy. Furthermore, metabolic abnormalities l inked to the insulin resistance syndrome are also observed in women with PI H to a greater degree than in normotensive pregnant women: These include gl ucose intolerance, hyperinsulinemia, hyperlipidemia, and high levels of pla sminogen activator inhibitor-1, leptin, and tumor necrosis factor-alpha. Th ese observations suggest the possibility that insulin resistance may be inv olved in the pathogenesis of PIH and that approaches that improve insulin s ensitivity might have benefit in the prevention or treatment of this syndro me, although this requires further study.