Hypertensive disorders in pregnancy represent severe complications of pregnancy, which, if not treated, can result in serious health consequences for the mother and the child. Flavonoids are bioactive secondary metabolites commonly found in fruits, vegetables, green tea, whole grains, and medicinal plants. Flavonoids exert potent protective efficacy in experimental models of hypertensive disorders in pregnancy, especially preeclampsia, demonstrated through their capacity to modulate inflammatory responses, oxidative stress, and vascular dysfunction. In addition to their potential as therapeutics, flavonoids or flavonoid-rich food could be helpful to decrease the risk of hypertensive disorders in pregnancy when included in the diet pattern before and during pregnancy. However, the clinical evaluation of the potential capacity of flavonoids in hypertensive disorders in pregnancy is insufficient. Due to promising results from experimental studies, we highlight the need for the evaluation of flavonoids also in an appropriate clinical setting, which can be, together with proper preventive strategies, helpful in the overall management of hypertensive disorders in pregnancy.

• Klíčová slova
• Flavonoids, Hypertensive disorders, Preeclampsia, Pregnancy,
• MeSH
• čaj MeSH
• dítě MeSH
• flavonoidy farmakologie   terapeutické užití   MeSH
• hypertenze indukovaná těhotenstvím * farmakoterapie   MeSH
• lidé MeSH
• preeklampsie * farmakoterapie   prevence a kontrola   MeSH
• těhotenství MeSH
• zelenina MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• čaj MeSH
• flavonoidy MeSH

Hypertensive disorders in pregnancy (HDP), remain the leading cause of adverse maternal, fetal, and neonatal outcomes. Epidemiological factors, comorbidities, assisted reproduction techniques, placental disorders, and genetic predisposition determine the burden of the disease. The pathophysiological substrate and the clinical presentation of HDP are multifarious. The latter and the lack of well designed clinical trials in the field explain the absence of consensus on disease management among relevant international societies. Thus, the usual clinical management of HDP is largely empirical. The current position statement of the Working Group 'Hypertension in Women' of the European Society of Hypertension (ESH) aims to employ the current evidence for the management of HDP, discuss the recommendations made in the 2023 ESH guidelines for the management of hypertension, and shed light on controversial issues in the field to stimulate future research.

• MeSH
• antihypertenziva terapeutické užití   MeSH
• hypertenze indukovaná těhotenstvím * terapie   MeSH
• kardiovaskulární komplikace v těhotenství terapie   patofyziologie   MeSH
• lidé MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• společnosti lékařské normy   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• antihypertenziva MeSH

Hypertensive disorders in pregnancy are associated with increased risk of maternal, fetal, and neonatal morbidity and mortality. It is important to distinguish between pre-existing (chronic) hypertension and gestational hypertension, developing after 20 weeks of gestation and usually resolving within 6 weeks postpartum. There is a consensus that systolic blood pressure ≥ 170 or diastolic blood pressure ≥ 110 mmHg is an emergency and hospitalization is indicated. The selection of the antihypertensive drug and its route of administration depend on the expected time of delivery. The current European guidelines recommend initiating drug treatment in pregnant women with persistent elevation of blood pressure ≥ 150/95 mmHg and at values > 140/90 mmHg in women with gestational hypertension (with or without proteinuria), with pre-existing hypertension with the superimposition of gestational hypertension, and with hypertension with subclinical organ damage or symptoms at any time during pregnancy. Methyldopa, labetalol, and calcium antagonists (the most data are available for nifedipine) are the drugs of choice. The results of the CHIPS and CHAP studies are likely to reduce the threshold for initiating treatment. Women with a history of hypertensive disorders in pregnancy, particularly those with pre-eclampsia, are at high risk of developing cardiovascular disease later in life. Obstetric history should become a part of the cardiovascular risk assessment in women.

• Klíčová slova
• Cardiovascular risk after hypertensive disorders in pregnancy, Classification of hypertensive disorders in pregnancy, Drug treatment of hypertension in pregnancy, Pre-conception counselling, Prevention of pre-eclampsia,
• MeSH
• antihypertenziva škodlivé účinky   MeSH
• hypertenze indukovaná těhotenstvím * diagnóza   farmakoterapie   epidemiologie   MeSH
• hypertenze * diagnóza   farmakoterapie   epidemiologie   MeSH
• krevní tlak MeSH
• labetalol * škodlivé účinky   MeSH
• lidé MeSH
• novorozenec MeSH
• preeklampsie * MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antihypertenziva MeSH
• labetalol * MeSH

Hypertensive disorders in pregnancy are a worldwide health problem for women and their infants complicating up to 10% of pregnancies and associated with increased maternal and neonatal morbidity and mortality. In Europe, 2.3-3% of pregnancies are complicated by preeclampsia. Gestational diabetes, obesity, no previous or multiple births, maternal age less than 20 or greater than 35years old and thrombophilia can be some of the possible factors related to increased risk for hypertension in pregnancy. Complications of hypertension during pregnancy affect both mothers and their infants. Ambulatory blood pressure monitoring helps to distinguish true hypertension from the white coat as pregnant women with office abnormal values may have normal out of office blood pressure. Imbalance between proangiogenic and antiangiogenic factors in placenta may lead to endothelial dysfunction, vasoconstriction, activation of the coagulation system, and hemolysis. Carotid intima-media thickness, pulse wave velocity, augmentation index, and arterial wall tension were found to be significantly increased in women with preeclampsia compared to normotensive pregnant women. Uterine artery Doppler and serum biomarkers can be used to evaluate the probability of hypertension and complications during pregnancy, but further research in the field is needed. Lately, micro ribonucleic acids have also been the focus of research as potential biomarkers.

• Klíčová slova
• Gestational hypertension, Preeclampsia, Pregnancy-induced hypertension,
• MeSH
• ambulantní monitorování krevního tlaku MeSH
• biologické markery krev   MeSH
• hypertenze indukovaná těhotenstvím * diagnóza   epidemiologie   patofyziologie   terapie   MeSH
• kardiovaskulární komplikace v těhotenství krev   epidemiologie   etiologie   MeSH
• krevní tlak fyziologie   MeSH
• lidé MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• biologické markery MeSH

OBJECTIVES: Older maternal age is considered to be a risk factor for a number of pregnancy-associated pathologies. Average weight increases with age. The aim of this study is to assess the effects of maternal age on selected disorders of pregnancy independently from the influence of maternal weight. METHODS: The retrospective study included 910 women. The following parameters were evaluated: age, p-BMI (body mass index before pregnancy), hypertension, severe hypertension, pre-eclampsia, proteinuria, severe proteinuria, thromboembolic diseases, pregnancy duration and fetal growth restriction. RESULTS: The correlation between the p-BMI and age and BMI was confirmed (P<0.001). After filtering away the mutual influence of age and p-BMI applying logistic regression we proved a statistically significant effect of p-BMI on the incidence of hypertension, severe hypertension, proteinuria and pre-eclampsia (P<0.001). The maternal age (cleared of the p-BMI) effects only hypertension. CONCLUSIONS: Age alone proved to be a risk factor for severe hypertension or severe hypertension of the pregnant subjects. Increased risk for proteinuria, hypertension and pre-eclampsia is directly associated with p-BMI of the pregnant women, and only indirectly with their age.

• MeSH
• dospělí MeSH
• hypertenze epidemiologie   patofyziologie   MeSH
• index tělesné hmotnosti * MeSH
• kardiovaskulární komplikace v těhotenství epidemiologie   patofyziologie   MeSH
• lidé MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• těhotenství MeSH
• věk matky * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Československo epidemiologie   MeSH

PURPOSE OF REVIEW: Many aspects of reproduction have been associated with increased blood pressure and impaired glucose metabolism that reveals a subsequent increased risk of cardiovascular disease. The aim of this review is to assess reproductive life factors associated with an increased risk of hypertension and cardiovascular disease, e.g., early life programming, sexual, and reproductive health in men and women. RECENT FINDINGS: Impaired fetal growth, with low birth weight adjusted for gestational age, has been found associated with hypertension in adulthood. Erectile dysfunction, currently considered an early diagnostic marker of cardiovascular disease preceding the manifestation of coronary artery disease by several years, frequently coexisting with hypertension, could also be exacerbated by some antihypertensive drugs. Male hypogonadism or subfertility are associated with increased cardiovascular risk. Hypertensive disorders in pregnancy including preeclampsia represent a major cause of maternal, fetal and neonatal morbidity, and mortality. The risk of developing preeclampsia can be substantially reduced in women at its high or moderate risk with a low dose of acetylsalicylic acid initiated from 12 weeks of gestation. An increased risk of hypertension in women following invasive-assisted reproductive technologies has been newly observed. Blood pressure elevation has been noticed following contraceptive pill use, around the menopause and in postmenopausal age. Furthermore, drug treatment of hypertension has to be considered as a factor with a potential impact on reproduction (e.g., due to teratogenic drug effects). In summary, a deeper understanding of reproductive life effects on hypertension and metabolic abnormalities may improve prediction of future cardiovascular disease.

• Klíčová slova
• Assisted reproductive technologies, Erectile dysfunction, Hypertensive disorders in pregnancy, Low birth weight, Male hypogonadism, Oral contraception,
• MeSH
• antihypertenziva MeSH
• dospělí MeSH
• hypertenze * MeSH
• kardiovaskulární nemoci * MeSH
• lidé MeSH
• novorozenec s nízkou porodní hmotností MeSH
• novorozenec MeSH
• preeklampsie * MeSH
• reprodukční zdraví * MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• antihypertenziva MeSH

Hypertensive disorders complicate approximately 10% of all pregnancies, about half due to transient and essential hypertension and the rest due to preeclampsia that continues to be a major contributor to maternal and perinatal mortality. However, when hypertensive pregnancies are carefully monitored, the neonatal mortality is low. Therefore, identification of women destined to have preeclampsia is essential, and it is the major purpose of the new classification proposed by M. A. Brown and M. L. Buddle to better stratify those hypertensive pregnant women who are at high risk and need intensive inpatient management. Prophylactic low-dose aspirin appeared to prevent preeclampsia in some studies and to be reasonably safe; however, the effectiveness in reducing the incidence of severe preeclampsia and improving pregnancy outcome remains uncertain. The basic therapy for hypertension during pregnancy is now hydralazine, labetalol and methyldopa; for preeclampsia the cornerstone for treatment is magnesium sulphate and hydralazine intravenously, and small doses of diazoxide, if necessary. Diuretics have a dubious place in treatment of hypertension during pregnancy, and ACE-inhibitors are contraindicated. In severe preeclampsia and eclampsia, the only solution is delivery; better knowledge of etiology and pathogenetics is needed for effective and safe treatment of gestational hypertension, as well as careful blood pressure monitoring and adequate laboratory control.

• MeSH
• hypertenze farmakoterapie   etiologie   prevence a kontrola   MeSH
• komplikace těhotenství farmakoterapie   prevence a kontrola   MeSH
• lidé MeSH
• preeklampsie farmakoterapie   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

Women undergo important changes in sex hormones throughout their lifetime that can impact cardiovascular disease risk. Whereas the traditional cardiovascular risk factors dominate in older age, there are several female-specific risk factors and inflammatory risk variables that influence a woman's risk at younger and middle age. Hypertensive pregnancy disorders and gestational diabetes are associated with a higher risk in younger women. Menopause transition has an additional adverse effect to ageing that may demand specific attention to ensure optimal cardiovascular risk profile and quality of life. In this position paper, we provide an update of gynaecological and obstetric conditions that interact with cardiovascular risk in women. Practice points for clinical use are given according to the latest standards from various related disciplines (Figure 1).

• Klíčová slova
• Coronary artery disease, Female-specific risk factors, Hypertensive pregnancy disorders, Ischaemic heart disease, Menopausal hormone therapy, Menopause, Sexual health women, Transgender,
• MeSH
• endokrinologové MeSH
• kardiologové * MeSH
• kardiovaskulární nemoci * epidemiologie   etiologie   MeSH
• konsensus MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• menopauza MeSH
• rizikové faktory MeSH
• senioři MeSH
• těhotenství MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The case report focuses on the case of heavy Graves - Basedow thyreotoxicosis in 33 years old secundipara who was transferred to our departement from regional hospital for decompensation of gestational hypertension, oligohydramnios and the suspition on intrauterine growth restriction (IUGR). In our clinical praxis the problems of thyroid gland in terms of its reduced function in pregnant women are getting more frequent. The goal of this article is to describe the less often situation, the hyperthyroidism in the third trimestr of the pregnancy. Thyretoxicosis in pregnancy is associated with higher risk of preterm labour, preeclampsia, IUGR, heart failure and stillbirth. Some of these complications confirmes our case report.

• Klíčová slova
• hyperthyroidism., pregnancy, thyreotoxicosis,
• MeSH
• dospělí MeSH
• hypertenze indukovaná těhotenstvím * MeSH
• hypertyreóza * MeSH
• komplikace těhotenství * MeSH
• lidé MeSH
• narození mrtvého plodu MeSH
• novorozenec MeSH
• oligohydramnion * MeSH
• předčasná porodní činnost MeSH
• preeklampsie MeSH
• růstová retardace plodu * MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND AND METHODS: Gestational hypertension (GH), preeclampsia (PE) and fetal growth restriction (FGR) may predispose to later onset of cardiovascular/cerebrovascular diseases. We examined if pregnancy complications induce postpartum alterations in gene expression of cardiovascular/cerebrovascular disease associated microRNAs. 29 microRNAs were tested in peripheral blood of women, compared between groups with a history of GH, PE, FGR and controls, and correlated with the severity of the disease regarding clinical signs, delivery date, and Doppler parameters. RESULTS: GH was associated with the up-regulation of miR-20a-5p, miR-143-3p, miR-146a-5p, miR-181a-5p, miR-199a-5p, miR-221-3p, and miR-499a-5p. The up-regulation of miR-17-5p, miR-20b-5p, miR-29a-3p, and miR-126-3p was a mutual phenomenon of GH and severe PE. GH and early PE were associated with up-regulation of miR-1-3p and miR-17-5p. GH and late PE showed up-regulation of miR-17-5p, miR-20b-5p, and miR-29a-3p. Severe PE induced up-regulation of miR-133a-3p and down-regulation of miR-130b-3p. MiR-133a-3p up-regulation was also observed in early PE. PE and/or FGR with abnormal Doppler parameters demonstrated up-regulation of miR-100-5p, miR-125b-5p, miR-133a-3p, and miR-145-5p. The combination screening was superior over using individual microRNAs for patients with GH, PE regardless of the severity of the disease, severe PE and early PE. A cardiovascular risk at patients with late PE, PE and/or FGR with abnormal Doppler parameters was identified more accurately using the single microRNA only. CONCLUSION: Epigenetic changes characteristic for cardiovascular/cerebrovascular diseases are present in women with a prior exposure to pregnancy complications. Screening of microRNAs may be used to identify patients at a higher risk of later development of cardiovascular/cerebrovascular diseases.

• Klíčová slova
• Cardiovascular/cerebrovascular diseases, MicroRNA, Pregnancy complications, Prevention, Risk, Screening,
• MeSH
• cerebrovaskulární poruchy diagnóza   genetika   MeSH
• dospělí MeSH
• genetický profil MeSH
• hypertenze indukovaná těhotenstvím diagnóza   genetika   MeSH
• kardiovaskulární nemoci diagnóza   genetika   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• mikro RNA genetika   MeSH
• následné studie MeSH
• pilotní projekty MeSH
• poporodní období genetika   MeSH
• preeklampsie diagnóza   genetika   MeSH
• prospektivní studie MeSH
• růstová retardace plodu diagnóza   genetika   MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• mikro RNA MeSH