Fig. 9.

Hypothetical scheme whereby obesity and obesity-related metabolic factors act in the cascade of events leading to enhancement of placental ischemia-induced hypertension. We propose that these metabolic factors may act individually or in combination to potentiate dysfunctional uteroplacental vascular remodeling, exaggerate the release of soluble placental factors into the maternal circulation, and to exaggerate the maternal cardiovascular-renal responses to these soluble placental-ischemia factors. This may occur in a feed-forward fashion subsequently exaggerating the downstream actions of these metabolic factors.