Editorial Commentary Preeclampsia The Role of Aldosterone in Hypertension and Inflammation

Preeclampsia (PE) is a syndrome characterized by hypertension, proteinuria, and edema, occurring in the third trimester of pregnancy. The current approach to diseases is to prevent and not only to treat the patients with overt forms. This is very important in PE, because it is associated with liver, kidney, heart, coagulative, and neurological complications. Macdonald-Wallis et al 1 have reported the measurement of blood pressure (BP) as a presumptive praecox characteristic of PE: at week 8 of pregnancy, BP was higher in patients who later developed PE than in normotensive healthy pregnant controls. The conclusion was that patients with early alteration of BP should be monitored during pregnancy for the risk of PE or treated before the full expression of the disease. The finding of BP in the upper normal range at the beginning of pregnancy could be interpreted either as a similar situation of BP previous pregnancy or as an early onset of subclinical PE. It is important to note that PE can develop even in the absence of the fetus, as, for example, in cases of hydatidiform mole, and that the clinical picture of PE disappears after birth or abortion, when the placenta is no longer present. The study is consistent with PE being the final step of a process that starts early in pregnancy or before. In any case, prevention of a disease requires knowledge of its pathogenesis and not only the availability of tests to identify