Sympathetic Nerve Hyperactivity and Nitric Oxide Levels on Blood Pressure Dynamics among Pregnant Women

 Abstract views: 59


  • Meli Doloksaribu Institut Kesehatan Sumatera Utara



Sympathetic Nerve Hyperactivity, Nitric Oxide Level, Normotensive pregnant women


Hypertension is a complication that most often occurs in pregnancy (5-10% of pregnancies). About 30% of hypertension is caused by chronic hypertension and 70% is caused by gestasional pre-eclampsia hypertension. Blood pressure is a hemodynamic parameter that is simple and easy to measure. Blood pressure describes a person’s hemodynamic situation. Studies show that the sympathetic nervous system plays an important role in the pathogenesis of hypertension, namely an increase in the activity of the sympathetic nervous system. The autonomic nervous system causes vasoconstriction and arterial dilatation to maintain blood pressure. The study aimed to determine the levels of nitric oxide and sympathetic nerve hyperactivity. This study used a prospective cohort study design. To assess the hyperactivity of the sympathetic nerves, a Cold Pressor Test was performed and the levels of Nitric Oxide were examined for blood serum samples using the Elisa Kit. Where the measurement is carried out once, namely during the second trimester of pregnancy, while the blood pressure of pregnant women is measured once a week and followed up to 24 weeks of gestation. The number of samples was 40 pregnant women who were selected by consecutive sampling. Data collection was carried out according to data collection procedures. The data obtained in a prospective cohort were used statistical analysis of the Mann Whitney test to see the relationship or correlation between Sympathetic Nerve Hyperactivity and Nitric Oxide Levels and Blood Pressure Dynamics. The results showed that the mother was hyperreactor (12.44 ± 5.811) and mother was normoreactor (10.46 ± 3.215). Bivariate analysis showed that there was no significant difference between sympathetic nerve hyperactivity and nitric oxide levels (p=0.172). It was concluded that sympathetic nerve activity did not have a significant relationship with the increase in nitric oxide levels.


Download data is not yet available.


Adriana M.L, et al., (2013). L-arginine-nitric oxide pathway and oxidative stress in plasma and platelets of patients with pre-eclampsia. Hypertension Research advance online publication, 11 April 2013. Doi: 10.1038/hr.2013.34.

Breno J.A, et al., (2016). Serum nitrate and NO levels in preeclampsia are higher than in normal pregnancy. Hypertension Pregnancy.Doi:10.3109/10641955.2016.1139718.

Castillo J., Rama R., & Davalos A. (2016). Nitric Oxide-Related Brain Damage in Acute Ischemic Stroke. Stroke AHA:31:852-857.

Departemen Kemenkes R.I (2016). Rencana Strategis Kementerian Kesehatan Tahun 2015-2019. Kepmenkes No.02.02/MENKES/52/2015.7.

DeQuattro et al., (2012). Blood preassure reactivity and sympathetic hyperactivity. American Journal of Hypertension:4.6245-6285.

Gray H.H., Dawkins K.D., Morgan J.M., & Simpson I.A. (2015). Lecture Notes: Kardiologi(4rd ed). Jakarta: Penerbit Erlangga:.57-62.

Hodzic J ,et al., (2017). Nitric Oxide Biosynthesis during normal pregnancy and pregnancy complicated by preeclampsia. Medicinski Glasik: Vol.14 No.2 August 2017. Doi:10.17392/915-17.

Kawano H., Michiya T., Yamamoto K., Sanada K., Gando Y., Tabata I., et al. (2017). Resistance Training in Men is Associated with Increase Arterial Stiffness and Blood Pressure but Does Not Adversely Affect Endothelial Pressor Test 93(2): 296-30.

Kemenkes RI (2014) Hipertensi, Indofatin. doi: 10.1177/109019817400200403.

Kemenkes RI (2016) 'Rencana Strategis Kementerian Kesehatan Tahun 2015-2019', Kepmenkes No.02.02/MENKES/52/2015, 7 April. doi:351.077 Ind r.

Kemenkes RI (2015). Profil Kesehatan Indonesia. Kementerian Kesehatan Republik Indonesia. Jakarta.

Luft FC. 2011. Twins in Cardiovascular Genetics Research. Hypertension 37(2): 350-6

Manembu, Mercy, Rumampuk, Jimmy Danes, Vennetia R. (2015). Pengaruh Posisi Duduk Dan Berdiri Terhadap Tekanan Darah Sistolik Dan Diastolik Pada Pegawai Negeri Sipil kabupaten Minahasa Utara

Martin A.M, Bindra R, Curcio P, Cicero S, Nicolaides KH. Screening for Preeclampsia and Fetal Growth Restriction by Uterine Artery Doppler at 11-14 weeks of Gestation. Ultrasound Obstetrics and Gynecologt 2011; l8: 583-586.

Motta-mejia, al. (2017) ‘Placental Vesicles Carry Active Endothelial Nitric Oxide Synthase and Their Activity is Reduced in Preeclampsia’. doi: 10.1161/hypertensionaha.117.09321.

Rajashekar RK., Niveditha Y., Ghost S. 2013. Blood Pressure Response to Cold Pressor Test in Sibling of Hypertensives. Indian J Physiol Pharmacol 47(4):453-8

Sakar, et al., (2015)' Association of endothelial nitric oxide synthase gene G894T polymorphism and serum nitric oxide levels in patients with preeclampsia and gestational hypertension' doi: 10.3109/14767058.2014.971748.

Saptono, I., Rea, H., dan Probo, W. (2013). Jalan Terjal Menurunkan Angka Kematian Ibu. Internasional NGO Forum on Indonesian Development (INFID) : Jakarta.

Sembiring R.L, et al., (2018). Pregnancy Induced Hypertension Accompanied With Anemia Potential Stunting of Newborns.10(6).pp.164-172. Doi:10.5539/gjhs.v10n6p164.

Shruti S, et al., (2017). Altered carnitine homeostasis is associated with decreased mitochondrial function and altered nitric oxide signaling in lambs with pulmonary hypertension. Am J Physiol Lung Cell Mol Physiol 294: L46–L56, 2008. First published November 16, 2007; doi:10.1152/ajplung.00247.2007.

Sirait A.M. (2017). Prevalensi Hipertensi Pada Kehamilan di Indonesia Dan Berbagai Faktor Yang Berhubungan (Riset Kesehatan Dasar 2007). pp. 103–109.

Syukri M, et al., (2014). The Comparison Cold Pressor Test On Student With And Without history Of Genetic Hypertension. Vol. V No.2. ISSN: 2087-2879.

Torill B, (2015). Increased counteracting effect of eNOS and nNOS on an alpa adrenergic rise in total peripheral vascular resistance in spontaneous hypertensive rats. Departement of Physiology, Institute of Basic Medical Sciences, University of Oslo, P.O.Box 1103, Blindern, 0317 Oslo, Norway.Doi:10.1016/j.cardiores.2005.04.006.

WHO et al. (2015) ‘Trends in maternal mortality: 1990 to 2015. Executive Summary’, WHO Library Cataloguing,

Youlin T, et al., (2014). Melatonin Theraphy Prevents Programmed Hypertension and Nitric Oxide Deficiency in Offspring Exposed to Maternal Caloric Restriction. Doi:org/10.1155/2014/283180




How to Cite

Doloksaribu, M. (2022). Sympathetic Nerve Hyperactivity and Nitric Oxide Levels on Blood Pressure Dynamics among Pregnant Women. Embrio : Jurnal Kebidanan, 14(1), 53–59.