Arterial stiffness in normal pregnancy as assessed by digital pulse wave analysis by photoplethysmography – A longitudinal study

Wowern, Emma von; Källén, Karin; Olofsson, Per

doi:10.1016/j.preghy.2018.11.002

Cited by 10 publications

(10 citation statements)

References 40 publications

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“…PPG-derived parameters may also have utility for identifying increased arterial stiffness or BP in pregnancy which can precede preeclampsia ( 36 ). It is important to identify preeclampsia early as it can result in maternal and fetal morbidity and mortality ( 223 ).…”

Section: Resultsmentioning

confidence: 99%

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Assessing hemodynamics from the photoplethysmogram to gain insights into vascular age: a review from VascAgeNet

Charlton

Paliakaitė‬‬‬

Pilt

et al. 2022

American Journal of Physiology-Heart and Circulatory Physiology

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The photoplethysmogram (PPG) signal is widely measured by clinical and consumer devices, and it is emerging as a potential tool for assessing vascular age. The shape and timing of the PPG pulse wave are both influenced by normal vascular ageing, changes in arterial stiffness and blood pressure, and atherosclerosis. This review summarises research into assessing vascular age from the PPG. Three categories of approaches are described: (i) those which use a single PPG signal (based on pulse wave analysis); (ii) those which use multiple PPG signals (such as pulse transit time measurement); and (iii) those which use PPG and other signals (such as pulse arrival time measurement). Evidence is then presented on the performance, repeatability and reproducibility, and clinical utility of PPG-derived parameters of vascular age. Finally, the review outlines key directions for future research to realise the full potential of photoplethysmography for assessing vascular age.

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Section: Resultsmentioning

confidence: 99%

“…PPG-equipped wearables such as smartwatches and fitness trackers present a potential approach for doing this. Current evidence on PPG-derived parameters is limited to complication-free pregnancies ( 36 ), and further research should investigate whether parameters change consistently before preeclampsia.…”

Section: Resultsmentioning

confidence: 99%

Assessing hemodynamics from the photoplethysmogram to gain insights into vascular age: a review from VascAgeNet

Charlton

Paliakaitė‬‬‬

Pilt

et al. 2022

American Journal of Physiology-Heart and Circulatory Physiology

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“…6,7 Maladaptive changes to these maternal haemodynamic processes can occur during gestation, increasing the risk of gestational hypertensive conditions. 2,4 Pre-eclampsia (PE) and gestational hypertension (GHTN) are pregnancy-specific disorders that pose a significant risk to pregnant women, with the World Health Organization (WHO) recognizing these conditions among the leading causes of maternal and foetal morbidity and mortality worldwide, along with haemorrhage and sepsis. [8][9][10] The exact cause of GHTN and PE are not well established; however, it has been identified that hypertensive conditions that present prior to 20 weeks of gestation (chronic HTN, GHTN) often advance to PE.…”

Section: Introductionmentioning

confidence: 99%

The effects of aerobic and resistance exercise on blood pressure in uncomplicated and at risk pregnancies: A systematic review and meta-analysis

Giles

Johnston

Kubler

et al. 2023

Womens Health (Lond Engl)

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Background: Regular exercise performed during pregnancy has been shown to reduce the risk of developing perinatal gestational hypertensive conditions. Further evidence on the exact parameters of exercise needed to explain these beneficial responses is required, within both uncomplicated and at-risk pregnancies. Objective: The aim of this systematic review and meta-analysis was to investigate the effects of aerobic and resistance exercise on blood pressure during pregnancy. Design: Systematic review and meta-analysis. Data Sources and Methods: An online search of six search engines was conducted up to February 2023. Randomized controlled trials, quasi-experimental, cohort, and longitudinal studies were included. Studies included an acute exercise bout or intervention of land-based aerobic and/or resistance exercise during any trimester in uncomplicated and at-risk pregnancies. Outcomes included mean arterial pressure (MAP), or systolic blood pressure (SBP) and diastolic blood pressure (DBP). Results: Following the removal of duplicates, 1538 articles were screened with 59 studies meeting the inclusion criteria for the review (randomized controlled trials (RCTs) n = 34, clinical trials n = 19, cohort n = 5 and cross-sectional n = 2), and 21 studies included in the meta-analysis. A random effects model was used with mean difference calculated in mmHg. Overall, there were no statistically significant effects of exercise on resting blood pressure (BP) outcomes in pregnant women with normal blood pressure compared to control/usual care populations following intervention (SBP mean diff -1.54 mmHg (favours intervention), p = 0.38; DBP mean diff -2.25 mmHg (favours intervention), p = 0.1; MAP mean diff -1.75 mmHg (favours intervention), p = 0.31). In at-risk pregnant women, both aerobic and combination exercise significantly reduced BP outcomes compared to control (SBP mean diff -3.91 mmHg, p < 0.01; DBP mean diff -2.9 mmHg, p = 0.01; MAP mean diff -2.38 mmHg, p = 0.01). Twenty-seven studies reported an acute increase in SBP and DBP during aerobic exercise, with no difference found between uncomplicated and at-risk pregnancies. Conclusions: Compared to usual care, aerobic and/or resistance exercise performed throughout uncomplicated pregnancy had no influence on blood pressure. Pregnant women with no diagnosed complications should be encouraged to exercise regularly due to the multitude of known benefits. In women who are at risk of, or diagnosed, with gestational hypertensive conditions during pregnancy, moderate to vigorous exercise during pregnancy improves blood pressure outcomes. Higher risk pregnancies may reduce their risk of future cardiovascular complications through regular exercise training during pregnancy. Registration: CRD42020159998.

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“…Specifically, a cfPWV of 10 m/s is considered an arbitrary cut-off for target organ damage indicating an increased risk of adverse cardiovascular events in the general population [23] , [24] ; however, risk has been reported to significantly increase starting at a cfPWV of 7.8 m/s [12] . While reference values for cfPWV have been established in the general population [23] , [25] , these have not been studied for men and women separately, and importantly they may not apply to pregnancy given the changes in AS that occur throughout pregnancy due to extensive hemodynamic alterations [26] . Although many studies have highlighted an association between PWV, PWA indices, CO, FMD and HDPs, there are currently no clinical reference values for these parameters that can serve to stratify risk for the development of HDPs [27] , [28] , [29] .…”

Section: Introductionmentioning

confidence: 99%

Arterial stiffness measurements in pregnancy as a predictive tool for hypertensive disorders of pregnancy and preeclampsia: Protocol for a systematic review and meta-analysis

Forrest

Bourgeois

Pichette

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

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Arterial stiffness in normal pregnancy as assessed by digital pulse wave analysis by photoplethysmography – A longitudinal study

Cited by 10 publications

References 40 publications

Assessing hemodynamics from the photoplethysmogram to gain insights into vascular age: a review from VascAgeNet

Assessing hemodynamics from the photoplethysmogram to gain insights into vascular age: a review from VascAgeNet

The effects of aerobic and resistance exercise on blood pressure in uncomplicated and at risk pregnancies: A systematic review and meta-analysis

Arterial stiffness measurements in pregnancy as a predictive tool for hypertensive disorders of pregnancy and preeclampsia: Protocol for a systematic review and meta-analysis

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