Differential effects of renin-angiotensine-aldosteron system inhibition, sympathoinhibition and low sodium diet on blood pressure in women with a history of preeclampsia: A double-blind, placebo-controlled cross-over trial (the PALM study)

Gerbrand A Zoet; Nina D Paauw; Jan H W Veerbeek; T Katrien J Groenhof; Wilko Spiering; Marianne C Verhaar; A Franx; A Titia Lely

doi:10.1016/j.preghy.2021.12.016

Differential effects of renin-angiotensine-aldosteron system inhibition, sympathoinhibition and low sodium diet on blood pressure in women with a history of preeclampsia: A double-blind, placebo-controlled cross-over trial (the PALM study)

Gerbrand A Zoet, Nina D Paauw, Jan H W Veerbeek, T Katrien J Groenhof, Wilko Spiering, Marianne C Verhaar, A Franx, A Titia Lely

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Abstract

Current guidelines lack sufficient evidence to recommend a specific blood pressure lowering strategy to prevent cardiovascular disease after preeclampsia. We conducted a double-blind cross-over trial to identify the most potent antihypertensive strategy: renin-angiotensin-aldosterone system (RAAS) inhibition (losartan), sympathoinhibition (moxonidine), low sodium diet and placebo (n = 10). Due to low inclusion rate our study stopped prematurely. Initiatory analyses showed no significant effect of antihypertensive strategy on office blood pressure and 24-hour blood pressure. However, nocturnal dipping was significantly higher on RAAS inhibition and low sodium diet compared to placebo and sympathoinhibition. Optimal cardiovascular prevention after preeclampsia should be further explored.

Original language	English
Pages (from-to)	173-175
Number of pages	3
Journal	Pregnancy Hypertension
Volume	27
Early online date	6 Jan 2022
DOIs	https://doi.org/10.1016/j.preghy.2021.12.016
Publication status	Published - Mar 2022

Keywords

Cross-over trial
Hypertension
Low sodium diet
Postpartum
Preeclampsia
Renin-angiotensin-aldosterone system inhibition
Sympathoinhibition

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Zoet, G. A., Paauw, N. D., Veerbeek, J. H. W., Groenhof, T. K. J., Spiering, W., Verhaar, M. C., Franx, A., & Titia Lely, A. (2022). Differential effects of renin-angiotensine-aldosteron system inhibition, sympathoinhibition and low sodium diet on blood pressure in women with a history of preeclampsia: A double-blind, placebo-controlled cross-over trial (the PALM study). Pregnancy Hypertension, 27, 173-175. https://doi.org/10.1016/j.preghy.2021.12.016

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title = "Differential effects of renin-angiotensine-aldosteron system inhibition, sympathoinhibition and low sodium diet on blood pressure in women with a history of preeclampsia: A double-blind, placebo-controlled cross-over trial (the PALM study)",

abstract = "Current guidelines lack sufficient evidence to recommend a specific blood pressure lowering strategy to prevent cardiovascular disease after preeclampsia. We conducted a double-blind cross-over trial to identify the most potent antihypertensive strategy: renin-angiotensin-aldosterone system (RAAS) inhibition (losartan), sympathoinhibition (moxonidine), low sodium diet and placebo (n = 10). Due to low inclusion rate our study stopped prematurely. Initiatory analyses showed no significant effect of antihypertensive strategy on office blood pressure and 24-hour blood pressure. However, nocturnal dipping was significantly higher on RAAS inhibition and low sodium diet compared to placebo and sympathoinhibition. Optimal cardiovascular prevention after preeclampsia should be further explored.",

keywords = "Cross-over trial, Hypertension, Low sodium diet, Postpartum, Preeclampsia, Renin-angiotensin-aldosterone system inhibition, Sympathoinhibition",

author = "Zoet, \{Gerbrand A\} and Paauw, \{Nina D\} and Veerbeek, \{Jan H W\} and Groenhof, \{T Katrien J\} and Wilko Spiering and Verhaar, \{Marianne C\} and A Franx and \{Titia Lely\}, A",

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year = "2022",

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doi = "10.1016/j.preghy.2021.12.016",

language = "English",

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Zoet, GA, Paauw, ND, Veerbeek, JHW, Groenhof, TKJ, Spiering, W , Verhaar, MC, Franx, A & Titia Lely, A 2022, 'Differential effects of renin-angiotensine-aldosteron system inhibition, sympathoinhibition and low sodium diet on blood pressure in women with a history of preeclampsia: A double-blind, placebo-controlled cross-over trial (the PALM study)', Pregnancy Hypertension, vol. 27, pp. 173-175. https://doi.org/10.1016/j.preghy.2021.12.016

Differential effects of renin-angiotensine-aldosteron system inhibition, sympathoinhibition and low sodium diet on blood pressure in women with a history of preeclampsia: A double-blind, placebo-controlled cross-over trial (the PALM study). / Zoet, Gerbrand A; Paauw, Nina D; Veerbeek, Jan H W et al.
In: Pregnancy Hypertension, Vol. 27, 03.2022, p. 173-175.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Differential effects of renin-angiotensine-aldosteron system inhibition, sympathoinhibition and low sodium diet on blood pressure in women with a history of preeclampsia

T2 - A double-blind, placebo-controlled cross-over trial (the PALM study)

AU - Zoet, Gerbrand A

AU - Paauw, Nina D

AU - Veerbeek, Jan H W

AU - Groenhof, T Katrien J

AU - Spiering, Wilko

AU - Verhaar, Marianne C

AU - Franx, A

AU - Titia Lely, A

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N2 - Current guidelines lack sufficient evidence to recommend a specific blood pressure lowering strategy to prevent cardiovascular disease after preeclampsia. We conducted a double-blind cross-over trial to identify the most potent antihypertensive strategy: renin-angiotensin-aldosterone system (RAAS) inhibition (losartan), sympathoinhibition (moxonidine), low sodium diet and placebo (n = 10). Due to low inclusion rate our study stopped prematurely. Initiatory analyses showed no significant effect of antihypertensive strategy on office blood pressure and 24-hour blood pressure. However, nocturnal dipping was significantly higher on RAAS inhibition and low sodium diet compared to placebo and sympathoinhibition. Optimal cardiovascular prevention after preeclampsia should be further explored.

AB - Current guidelines lack sufficient evidence to recommend a specific blood pressure lowering strategy to prevent cardiovascular disease after preeclampsia. We conducted a double-blind cross-over trial to identify the most potent antihypertensive strategy: renin-angiotensin-aldosterone system (RAAS) inhibition (losartan), sympathoinhibition (moxonidine), low sodium diet and placebo (n = 10). Due to low inclusion rate our study stopped prematurely. Initiatory analyses showed no significant effect of antihypertensive strategy on office blood pressure and 24-hour blood pressure. However, nocturnal dipping was significantly higher on RAAS inhibition and low sodium diet compared to placebo and sympathoinhibition. Optimal cardiovascular prevention after preeclampsia should be further explored.

KW - Cross-over trial

KW - Hypertension

KW - Low sodium diet

KW - Postpartum

KW - Preeclampsia

KW - Renin-angiotensin-aldosterone system inhibition

KW - Sympathoinhibition

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DO - 10.1016/j.preghy.2021.12.016

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JO - Pregnancy Hypertension

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ER -

Zoet GA, Paauw ND, Veerbeek JHW, Groenhof TKJ, Spiering W , Verhaar MC et al. Differential effects of renin-angiotensine-aldosteron system inhibition, sympathoinhibition and low sodium diet on blood pressure in women with a history of preeclampsia: A double-blind, placebo-controlled cross-over trial (the PALM study). Pregnancy Hypertension. 2022 Mar;27:173-175. Epub 2022 Jan 6. doi: 10.1016/j.preghy.2021.12.016

Differential effects of renin-angiotensine-aldosteron system inhibition, sympathoinhibition and low sodium diet on blood pressure in women with a history of preeclampsia: A double-blind, placebo-controlled cross-over trial (the PALM study)

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