Interpretation of findings
We hypothesised that the four subgroups of women with CH represent
different stages of the disease. Studies in non-pregnant individuals
have demonstrated that in the progression from normal blood pressure to
mild and then severe hypertension there is increasing endothelial
dysfunction. Groups 1 and 2 are likely to represent the early phase of
CH with mild endothelial dysfunction but sufficient ability to achieve
physiological adaptation to pregnancy with normalisation of BP in the
latter group. Groups 3 and 4 may represent moderate to severe
endothelial dysfunction with less capacity to achieve early vasodilation
and normalisation in BP without antihypertensive medications. We further
postulated that the severity of underlying endothelial disease, as
represented by the four groups, might be reflected in the first
trimester angiogenic and inflammatory profiles.