B-Type Natriuretic Peptide (BNP) and Hypertensive Disorders in Pregnancy [31H]

Abstract

INTRODUCTION: B type natriuretic peptide (BNP) is a sensitive marker discerning early cardiac dysfunction and has demonstrated correlation with volume expansion and pressure overload in hypertensive disorders in pregnancy. The purpose of this study is to examine variations of BNP values in women with chronic hypertension and severe preeclampsia as indications for delivery. METHODS: Pregnant women greater than 20 weeks gestation and women up to 14 days postpartum presenting at Touro Infirmary in New Orleans between April 1, 2015 and May 30, 2017 for hypertension evaluation were eligible for inclusion. After informed consent, BNP values were collected at any evaluation for hypertension during the antepartum period, at admission for delivery and up to 14 days postpartum. 132 women were included. A BNP value above 100 pg/dL was considered elevated. Standards for hypertension and preeclampsia were determined by criteria described by the American College of Obstetrics and Gynecology. RESULTS: Of 18 women with chronic hypertension exacerbation as an indication for delivery, none had an elevated BNP, as compared to 24.6% of women without the indication (n =132, p=0.0248). Of 43 women with severe preeclampsia as an indication for delivery, 37.2% had an elevated BNP, as compared to 13.5% of women without the indication (p=0.003). CONCLUSION: Women with chronic hypertension exacerbation as an indication for delivery are not likely to have elevated BNP. Women with severe preeclampsia as an indication for delivery are more likely to have elevated BNP, which is congruent with the notion that BNP is a measure of acute stress to the heart.

Assessment of brain natriuretic peptide and copeptin as correlates of blood pressure in chronic hypertensive pregnant women

“…This observation may be explained by the fact that these women have been on antihypertensive medications which possibly have modulatory effects on BNP release. Again, chronic hypertensives without superimposed preeclampsia would most likely not have acute stress to the heart, hence no significant increase in BNP release as demonstrated in a previous study [ 27 ]. Also, no significant difference in mean plasma copeptin levels was observed between women with chronic hypertensive and the normotensive controls.…”