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Variable effect of the post-partum menstrual cycle on aldosterone and renin in women with recent preeclampsia


The purpose of the present study is to identify the impact of the postpartum menstrual cycle on aldosterone, renin, and their ratio of women with and without a preeclamptic pregnancy in the past. To this end, we analysed the data from 59 women with a history of preeclampsia and 39 healthy parous controls. Five to seven months post-partum, we measured aldosterone, renin, and the aldosterone-to-renin ratio during both the follicular and the luteal phase of the menstrual cycle. All measurements were taken in the supine position in the morning. Patients had maintained a standardized sodium diet in the week prior to the measurements. Our results show that in both post-partum women with recent preeclampsia and controls, average levels of renin and aldosterone are significantly elevated in the luteal phase as compared to the follicular phase. The aldosterone-to-renin ratio does not differ between the two phases in either group. Compared to controls, women with recent preeclampsia have significantly lower levels of renin, aldosterone, and aldosterone-to-renin ratio in the follicular phase. This remained consistent in the luteal phase, except for renin. A close correlation existed between the luteal and follicular aldosterone-to-renin ratio in the control group but not in the preeclampsia group. We conclude that both renin and aldosterone are significantly affected by the menstrual cycle whereas the resulting aldosterone-to-renin ratio is not. Post-partum women with recent preeclampsia tend to have lower values for aldosterone and the aldosterone-to-renin ratio than controls.

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Fig. 1: Distributions of renin, aldosterone and the ARR during the two phases of the menstrual cycle.
Fig. 2: Scatterplot of changes in aldosterone concentration in relation to changes in renin.
Fig. 3: Scatterplot of the relationship between the aldosterone-to-renin ratio (ARR) in the follicular and that in the luteal phase.

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The data used in this study are available from the authors upon reasonable request.


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This study was performed under the auspices of the university without external financial sources.

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Authors and Affiliations



GPV and RMA acquired the data, drafted, and revised the manuscript and approved the final version. AAK, MEAS and PWdL conceived and designed the work, revised, and approved the manuscript. All authors had full access to the data and take responsibility for all aspects of the work.

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Correspondence to Peter W. de Leeuw.

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The authors declare no competing interests.

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The present study was performed in accordance with all relevant guidelines and regulations and the Declaration of Helsinki. The study received ethical approval from the Medical Research Ethics Committee of the Maastricht University Medical Center (Decision NL47252.068.14).

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Veldhuizen, G.P., Alnazer, R.M., Kroon, A.A. et al. Variable effect of the post-partum menstrual cycle on aldosterone and renin in women with recent preeclampsia. J Hum Hypertens (2024).

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