Dear members of the International Society for the Study of Hypertension in Pregnancy,
It is my sincere pleasure to welcome you to the charming city of Montpellier for this scientific event, which we hope will meet with great success. Montpellier is in the middle of an axis joining Spain to the Italian borders and was populated by prehistoric humans for more than 11,000 years. The city’s name appeared officially at the end of the Xe century. It is one of the first European medieval cities hosting a medical university from 1220 after its foundation by Conrad, Cardinal of the Pope Honorius III. Expelled from Spain, Jewish and Arab physicians settled in the city for its faculty, as described by the wanderer Rabbi Benjamin of Tudela in his multiple peregrinations. The geographic position of the city made it a crossroad where educated people could exchange their knowledge and build medical practice.
There is a strong medical tradition in the sunny city of Montpellier, and the organization of our congress reinforces the solid bond which formerly existed between the place and the most current achievements of medical art.
In recent years, in many countries, a strong awareness has developed as to the need to face the specificities of the medical situation encountered specifically by women, which may differ from those encountered by men, although expressed similarly (hypertension, cardiovascular disease, nephropathy, etc.). These differences are visible in the manifestations of the disease and in their long-term consequences.
Among the specificities of women's health, pregnancy is a peculiar period of life that challenges the homeostasis of the maternal body. During nine months, the mother body will be inhabited by a second organism that is genetically different, a semi-allograft. Suboptimal materno-foetal immunological dialogue leads to poor placentation, inflammation, oxidative stress, and the retrograde circulation of distress molecular molecules from the placenta to the mother. Alterations of kidney function deregulate the blood pressure homeostasis, leading to maternal hypertension, which, when combined with proteinuria, is called preeclampsia. This ailment can have disastrous consequences for the mother and on the foetal health. It is a major cause of iatrogenic prematurity. Long term consequences include an increased risk of kidney dysfunction, cardiovascular diseases, or neurological disorders; some are also shared later by the offspring.
The recent years brought to the field of placental diseases the most modern tools of molecular and cellular biology. Today, high-throughput multi-omics methods (transcriptome, methylome, proteome, metabolome) have been used in the field of placental research. Bioinformatics tools allowed to pinpoint the most relevant hub genes involved in preeclampsia and in pregnancy-related hypertension. Single-cell analysis of the placenta is an explosive field of research, with the accompanying development of outstanding bioinformatic tools, including artificial intelligence and machine learning approaches. The systematic screen for new medications with the repositioning of existing drugs, the improved follow-up of the patients, the profusion of potential biomarkers, the surge of biophysics, the creation of placental organoïds, their targeted modifications through the development of powerful gene-editing technologies, are all recent tools that contribute to shape the research in the field of hypertension in pregnancy, and that will contribute to develop it in the years to come. Through the various sessions of our congress, we will attempt to cover the most recent achievements of academic and clinical research in the world, this research certainly contributing to a substantial improvement of the follow-up of the patients, especially in developed countries, thus considerably enhancing their quality of life during pregnancy and after.
Chair of ISSHP 2022