Significance of masked and nocturnal hypertension in normotensive women coursing a high-risk pregnancy

Salazar, Martín R.; Espeche, Walter G; Sisnieguez, Betty C Leiva; Balbín, Eduardo; Sisnieguez, Carlos Enrique Leiva; Stavile, Rodolfo N.; March, Carlos; Grassi, Florencia; Santillan, Claudia; Cor, Susana; Carbajal, Horacio A

doi:10.1097/hjh.0000000000001067

Cited by 46 publications

(24 citation statements)

References 15 publications

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“…In addition, several studies demonstrated that statins reduced levels of LDL/VLDL particles, which may improve blood viscosity, reduce the burden of free oxygen radicals and pro‐inflammatory cytokines and reduce peripheral vascular resistance, thus resulting in reduced BP levels, mostly diastolic BP . These effects may have potential clinical implications, mostly in view of the strict and significant relationship between nighttime BP levels and increased risk of cardiovascular and cerebrovascular events . Our findings, in fact, demonstrated that statin use was associated with a reduced diastolic BP load during both 24‐hour and nighttime periods, which may translate into effective cardiovascular disease prevention.…”

Section: Discussionmentioning

confidence: 52%

Effects of different statin types and dosages on systolic/diastolic blood pressure: Retrospective analysis of 24‐hour ambulatory blood pressure database

Presta¹,

Figliuzzi²,

Citoni³

et al. 2018

J of Clinical Hypertension

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Essential hypertension is related to an increased risk of major cardiovascular events such as myocardial infarction, stroke, congestive heart failure, and end-stage renal disease, making it the most common cardiovascular risk factor in the global adult population. various statin types and dosages, except in lower clinic (P = .007) and daytime (P = .013) diastolic BP in patients treated with simvastatin and atorvastatin compared to other statins. Favorable effects of statins on systolic/diastolic BP levels seem to be independent of types or dosages, thus suggesting a potential class effect of these drugs.

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Section: Discussionmentioning

confidence: 52%

Effects of different statin types and dosages on systolic/diastolic blood pressure: Retrospective analysis of 24‐hour ambulatory blood pressure database

Presta¹,

Figliuzzi²,

Citoni³

et al. 2018

J of Clinical Hypertension

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“…Various studies showed that nocturnal BP might be relevant in pregnancy. 13 In our study, we showed that females who show the absence of a physiological decrease in nocturnal BP (nondipper profile), especially the diastolic values, are important causes of adverse maternal-fetal events, which present superior and independent value in relation to the physiological decrease of BP values (dipper profile). According to the MEDLINE database in 2015, which scrutinized various articles from 2015, around 2000 studies showed the benefits of ABPM in confirming the diagnosis without false positive recordings, prognosis, and assessment of drug efficacy.…”

Section: Discussionmentioning

confidence: 77%

Role of Ambulatory Blood Pressure Monitoring in Predicting Adverse Maternofetal Events in Pregnancy

Vavilala

Garre

Beeram

2021

IJCDW

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Aims To correlate the relationship between the ambulatory blood pressure parameters and the occurrence of the antenatal and postnatal adverse maternofetal events in pregnancy. Methods Observational study designed for 50 pregnant patients who had an appointment to the obstetrics with abnormal blood pressure (BP) measurements and for whom ambulatory blood pressure monitoring (ABPM) was studied between January 2019 and June 2019. Data about age, personal history, obstetrics, family, body mass index (BMI), weight gain in pregnancy, values of blood pressure in the appointment, values recorded in ABPM, delivery and newborn, pregnancy and postpartum events, and follow-up of woman and child. Data were analyzed using descriptive and inferential statistics with Minitab 17.0 for Windows. Results Patients demographic data, clinical history, and laboratory results, including the ABPM parameters, were compiled. Antenatal complications occurred in 22 patients (44%), and postpartum complications were found in 41 patients (82%) whose ABPM values were deranged. Antenatal complications were studied using the binary logistic regression analysis for calculating the role each factor played in the development of hypertension. In the sample studied, mean age was 24.980 with a standard deviation of 4.876 (p = 0.003; minimum age of 19 years and maximum age of 38 years), mean weight of patient was 63.71 with a standard deviation of 63.71 (p = 0.001), mean gravida was 1.780 with a standard deviation of 0.910 (p = 0.034), mean gestation weeks at presentation was 33.000 weeks with a standard deviation of 4.086 (p = 0.041), mean birth weight was 2.226 with a standard deviation of 0.797 (p = 0.000), mean maximum diastole was 109.22 with a standard deviation of 16.53 (p = 0.002), mean day maximum systole was 187.2 with a standard deviation of 203.5 (p = 0.009), mean day minimum diastole was 63.50 with a standard deviation of 12.99 (p = 0.013), all of which had statistical significance. It is found that the nighttime diastolic blood pressure (DBP) and daytime maximum systolic blood pressure (SBP) were the best predictors of adverse events. Among antenatal complications (ANC), the most common complication is intrauterine growth restriction (IUGR), noted in (n = 19, 86.36%) preterm delivery (n = 17, 77.27%) among the 17 babies who were delivered preterm; 12 (70.5%) needed neonatal intensive care unit (NICU) care of which 4 (25%) babies died because of prematurity; intrauterine death (IUD) was noted in 7 (31.81%) patients and eclampsia was seen in 5 (22.72%). Nondippers proðle had a worse survival rate at follow-up until delivery compared with those with a dipper proðle. Postnatal complications were seen in 41 patients; among them, 13 patients (31.7%) had abnormal fundus examination, 15 patients (36.58%) required usage of antihypertensive beyond first postpartum, 9 patients (21.95%) required blood transfusion for severe bleeding in the form of postpartum hemorrhage. Binary logistic regression for systolic dippers versus nondippers shows statistical significance in age (p = 0.023), weight (p = 0.038), and para (p = 0.045) (Table 3). Binary logistic regression for diastolic dippers versus nondippers shows statistical significance in age (p = 0.039), weight (p = 0.020), birth weight (p = 0.010), maximum heart rate (p = 0.043), and ANC (p = 0.007) Adverse events occurred most commonly in nondippers. Systole nondippers is noted in (n = 41, 82%). Dippers is noted in (n = 9, 18%), Diastole nondippers is noted in (n = 39, 78%) Dippers is noted in (n = 11, 22%). Conclusion ABPM recorded blood pressure is very precise. ABPM is the advised method for both diagnostic and therapeutic monitoring of hypertensive pregnancy diseases, mainly in situations like whitecoat hypertension, masked hypertension, nocturnal hypertension, and nondipping profile. In patients with high-risk pregnancy, elderly primigravida, and precious pregnancy, who have a high-risk of developing pregnancy-induced hypertension (PIH) and related complications, early use of ABPM predicts adverse maternofetal events, which when intervened at an earlier date can prevent antenatal and postnatal complications.

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“…It shows characteristic circadian pattern in all individuals, including non-pregnant and pregnant women in response to internal clock and mental and physical activity [11]. As others studies, the ABPM has been demonstrated to improve the diagnostic approach and the risk prediction in a general hypertensive population, and evidence is available also to support their usefulness in the management of hypertensive disorders in pregnancy [11][12][13]. ABPM has been speci ically recommended for the identi ication of white-coat hypertension and the presence of masked hypertension because it allows evaluate the elevation in daytime BP, night-time BP or both [14].…”

Section: Discussionmentioning

confidence: 99%

“…ABPM has been speci ically recommended for the identi ication of white-coat hypertension and the presence of masked hypertension because it allows evaluate the elevation in daytime BP, night-time BP or both [14]. Although previous studies did already suggest that nocturnal BP may be relevant in pregnancy [13], in our study we showed that the absence of physiological decrease in nocturnal blood pressure (non-dipper pro ile), especially diastolic values, are related to the appearance of adverse maternal-fetal events, presenting superior and independent value in relation to the physiological decrease of blood pressure values (dipper pro ile). On our study nocturnal hypertension has a strong power as predictor for the development of adverse events in pregnancy when is adjusted for other potential confounders, being the nocturnal diastolic values the best predictors remaining statistically signi icant after adjustment for the other ABPM values.…”

Section: Discussionmentioning

confidence: 99%

Value of ambulatory blood pressure measure in pregnancy hypertension

Ana*¹,

Fátima²

2018

Clin J Obstet Gynecol

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It is still not well known the prognostic cardiovascular value of 24h ambulatory blood pressure monitoring in the pregnant woman with hypertension.Objectives: Assess to the prognostic value of ABPM parameters in predicting maternofetal event.Methods: Retrospective and observational study which included 166 pregnant women. Results:The authors found that the night time DBP was the best predictor of adverse events. Non-dipper profi le had worse survival at follow up until delivery compared to those with a dipper profi le.Conclusions: ABPM is a tool for pregnant with HT because this is the unique method available that analyses the night blood pressure.

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Significance of masked and nocturnal hypertension in normotensive women coursing a high-risk pregnancy

Abstract: Masked and nocturnal hypertension are frequent findings in normotensive women coursing a high-risk pregnancy, and their presence implies an increased risk to develop PEEC.

Cited by 46 publications

References 15 publications

Effects of different statin types and dosages on systolic/diastolic blood pressure: Retrospective analysis of 24‐hour ambulatory blood pressure database

Effects of different statin types and dosages on systolic/diastolic blood pressure: Retrospective analysis of 24‐hour ambulatory blood pressure database

Role of Ambulatory Blood Pressure Monitoring in Predicting Adverse Maternofetal Events in Pregnancy

Value of ambulatory blood pressure measure in pregnancy hypertension

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