Ambulatory arterial stiffness index and nocturnal blood pressure dipping in pregnancies complicated by hypertension

Kärkkäinen, Henna; Saarelainen, Heli; Laitinen, Tomi; Heiskanen, Nonna; Valtonen, Pirjo; Laitinen, Tiina M; Vanninen, Esko; Heinonen, Seppo

doi:10.1111/cpf.12063

Cited by 5 publications

(2 citation statements)

References 30 publications

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“…The prevalence of non-dipping observed in this cohort is greater than has been reported in several prominent observational studies of ABPM parameters, including 27.8% non-dipping rate reported in the PIUMA study among 959 individuals with ambulatory hypertension in Italy [47], and the 29.4% non-dipping rate reported within the IDACO cohort of 7458 individuals [48]. Non-dipping has been associated with adverse cardiovascular outcomes in a variety of European, American, and Asian cohorts [46, 49], including associations among pregnant women with pregnancy-induced hypertension [50] and increased risk of endothelial damage in preeclampsia [51]. Studies in the United States point to a potential racial and ethnic component of non-dipping patterns, with a larger prevalence of non-dipping SBP observed among African-Americans as compared to other racial groups [52, 53].…”

Section: Discussionmentioning

confidence: 99%

Ambulatory monitoring demonstrates an acute association between cookstove-related carbon monoxide and blood pressure in a Ghanaian cohort

et al. 2017

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BackgroundRepeated exposure to household air pollution may intermittently raise blood pressure (BP) and affect cardiovascular outcomes. We investigated whether hourly carbon monoxide (CO) exposures were associated with acute increases in ambulatory blood pressure (ABP); and secondarily, if switching to an improved cookstove was associated with BP changes. We also evaluated the feasibility of using 24-h ambulatory blood pressure monitoring (ABPM) in a cohort of pregnant women in Ghana.MethodsParticipants were 44 women enrolled in the Ghana Randomized Air Pollution and Health Study (GRAPHS). For 27 of the women, BP was measured using 24-h ABPM; home blood pressure monitoring (HBPM) was used to measure BP in the remaining 17 women. Personal CO exposure monitoring was conducted alongside the BP monitoring.ResultsABPM revealed that peak CO exposure (defined as ≥4.1 ppm) in the 2 hours prior to BP measurement was associated with elevations in hourly systolic BP (4.3 mmHg [95% CI: 1.1, 7.4]) and diastolic BP (4.5 mmHg [95% CI: 1.9, 7.2]), as compared to BP following lower CO exposures. Women receiving improved cookstoves had lower post-intervention SBP (within-subject change in SBP of −2.1 mmHg [95% CI: -6.6, 2.4] as compared to control), though this result did not reach statistical significance. 98.1% of expected 24-h ABPM sessions were successfully completed, with 92.5% of them valid according to internationally defined criteria.ConclusionsWe demonstrate an association between acute exposure to carbon monoxide and transient increases in BP in a West African setting. ABPM shows promise as an outcome measure for assessing cardiovascular health benefits of cookstove interventions.Trial registrationThe GRAPHS trial was registered with clinicaltrials.gov on 13 April 2011 with the identifier NCT01335490.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-017-0282-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Ambulatory monitoring demonstrates an acute association between cookstove-related carbon monoxide and blood pressure in a Ghanaian cohort

et al. 2017

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“…As an example, the augmentation index (AI) and pulse wave velocity (PWV), which are intrinsically related to elasticity of the arterial wall, are commonly used to assess arterial stiffness. Thus, patients diagnosed with early onset preeclampsia displayed more pronounced AI and PWV after delivery [88] and were also more susceptible to develop postpartum metabolic syndrome [89] than respective controls. Indeed, augmented AI and PWV may still be observed one year after preeclampsia [90], reinforcing the concept that endothelial dysfunction is not totally restored after delivery.…”

Section: Cardiovascular Diseases In Women Who Had Preeclampsiamentioning

confidence: 97%

Vascular Dysfunction in Mother and Offspring During Preeclampsia: Contributions from Latin-American Countries

et al. 2017

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Pregnancy is a physiologically stressful condition that generates a series of functional adaptations by the cardiovascular system. The impact of pregnancy on this system persists from conception beyond birth. Recent evidence suggests that vascular changes associated with pregnancy complications, such as preeclampsia, affect the function of the maternal and offspring vascular systems, after delivery and into adult life. Since the vascular system contributes to systemic homeostasis, defective development or function of blood vessels predisposes both mother and infant to future risk for chronic disease. These alterations in later life range from fertility problems to alterations in the central nervous system or immune system, among others. It is important to note that rates of morbi-mortality due to pregnancy complications including preeclampsia, as well as cardiovascular diseases, have a higher incidence in Latin-American countries than in more developed countries. Nonetheless, there is a lack both in the amount and impact of research conducted in Latin America. An impact, although smaller, can be seen when research in vascular disorders related to problems during pregnancy is analyzed. Therefore, in this review, information about preeclampsia and endothelial dysfunction generated from research groups based in Latin-American countries will be highlighted. We relate the need, as present in many other countries in the world, for increased effective regional and international collaboration to generate new data specific to our region on this topic.

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Preeclampsia is associated with increased ambulatory arterial stiffness index in type 1 diabetes mellitus

Al-Far

Tjessem

Fuglsang

et al. 2017

European Journal of Obstetrics & Gynecology and Reproductiv

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Ambulatory arterial stiffness index and nocturnal blood pressure dipping in pregnancies complicated by hypertension

Abstract: A hypertensive disorder during pregnancy was associated with a flattened circadian blood pressure response, which was restored after delivery. Higher arterial stiffness predicted the signs of postpartum metabolic syndrome and correlated also with non-dipping, especially postpartum.

Cited by 5 publications

References 30 publications

Ambulatory monitoring demonstrates an acute association between cookstove-related carbon monoxide and blood pressure in a Ghanaian cohort

Ambulatory monitoring demonstrates an acute association between cookstove-related carbon monoxide and blood pressure in a Ghanaian cohort

Vascular Dysfunction in Mother and Offspring During Preeclampsia: Contributions from Latin-American Countries

Preeclampsia is associated with increased ambulatory arterial stiffness index in type 1 diabetes mellitus

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