The prevalence and clinical significance of nocturnal hypertension in pregnancy

Brown, Mark; Davis, Gregory K.; McHugh, Lisa

doi:10.1097/00004872-200108000-00012

Cited by 60 publications

(43 citation statements)

References 13 publications

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“…11,36,37 In the present study, the prevalence of sleep hypertension among 31 women with preeclampsia was 68%. Furthermore, we found that non-dippers and dippers with preeclampsia differ not only in their hemodynamic response during night, but also in their physiological response to darkness, as shown by the blunted nocturnal melatonin secretion in non-dippers.…”

Section: Discussionsupporting

confidence: 44%

“…9 Patients with preeclampsia are frequently characterized by abnormal circadian BP rhythm with elevated BP during sleep. 10,11 An interesting observation is that the reduction in nocturnal BP fall has a high prevalence among pregnant women with severe preeclampsia and that these women have a greater frequency of adverse maternal and fetal outcomes. 12 Although the reasons for this nocturnal hypertension in preeclampsia are poorly understood, there is evidence that abnormalities in sympathetic nervous system activity could play a pivotal role.…”

Section: Introductionmentioning

confidence: 99%

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Melatonin secretion is impaired in women with preeclampsia and an abnormal circadian blood pressure rhythm

et al. 2014

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Non-dipping circadian blood pressure (BP) is a common finding in preeclampsia, accompanied by adverse outcomes. Melatonin plays pivotal role in biological circadian rhythms. This study investigated the relationship between melatonin secretion and circadian BP rhythm in preeclampsia. Cases were women with preeclampsia treated between January 2006 and June 2007 in the University Hospital of Larissa. Volunteers with normal pregnancy, matched for chronological and gestational age, served as controls. Twenty-four hour ambulatory BP monitoring was applied. Serum melatonin and urine 6-sulfatoxymelatonin levels were determined in day and night time samples by enzyme-linked immunoassays. Measurements were repeated 2 months after delivery. Thirty-one women with preeclampsia and 20 controls were included. Twenty-one of the 31 women with preeclampsia were non-dippers. Compared to normal pregnancy, in preeclampsia there were significantly lower night time melatonin (48.4 ± 24.7 vs. 85.4 ± 26.9 pg/mL, p50.001) levels. Adjustment for circadian BP rhythm status ascribed this finding exclusively to non-dippers (p50.01). Two months after delivery, in 11 of the 21 non-dippers both circadian BP and melatonin secretion rhythm reappeared. In contrast, in cases with retained non-dipping status (n ¼ 10) melatonin secretion rhythm remained impaired: daytime versus night time melatonin (33.5 ± 13.0 vs. 28.0 ± 13.8 pg/mL, p ¼ 0.386). Urinary 6-sulfatoxymelatonin levels were, overall, similar to serum melatonin. Circadian BP and melatonin secretion rhythm follow parallel course in preeclampsia, both during pregnancy and, at least 2 months after delivery. Our findings may be not sufficient to implicate a putative therapeutic effect of melatonin, however, they clearly emphasize that its involvement in the pathogenesis of a non-dipping BP in preeclampsia needs intensive further investigation.

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Section: Discussionsupporting

confidence: 44%

Section: Introductionmentioning

confidence: 99%

Melatonin secretion is impaired in women with preeclampsia and an abnormal circadian blood pressure rhythm

et al. 2014

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“…19 History of pre-pregnancy HT was a significant risk factor associated with early-onset severe PE in univariate analysis (RR 2.14), which is in agreement with other studies. Brown and colleagues 20 found that the prevalence of chronic HT was higher in women who develop PE than women who do not (12.1% vs 0.3%).…”

Section: Discussionmentioning

confidence: 98%

Risk factors for pre-eclampsia among women at antenatal booking in Kano, Northern Nigeria

Yakasai

Morhason-Bello

2013

Healthc Low Resour Settings

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Pre-eclampsia (PE) is an important cause of maternal mortality. There have been several studies on risk factors assessment with conflicting reports across the globe on this disease; however, rigorous recent evaluation of these factors is uncommon in this region. The aim of the present study was to determine the risks factors in the early-onset PE in Aminu Kano Teaching Hospital (AKTH), Kano (Northern Nigeria). We conducted a case-control study in Nigeria between April 2009 and January 2010 to identify the risk factors associated with the early-onset PE in women attending antenatal clinic in AKTH. Information on socio-cultural characteristics, medical history, previous obstetrics history, level of stress at home, and type of family were obtained and recorded in a proforma designed for the study. Multiple logistic regression analysis was used to determine the risk factors for PE at 95% confidence level. Pregnant women with early-onset PE (150 in each case and control group). Risk factors associated with increased risk of early-onset PE were: history of pre-eclampsia/eclampsia (PE/E) in a previous pregnancy [adjusted odds ratio (AOR) 2.09]; exposure to passive smoking (AOR 1.34); inadequate antenatal supervision (AOR 15.21); family history of hypertension in one or more 1 st -degree relative (AOR 8.92); living in a joint family (AOR 6.93); overweight (120% to 150% of pre-pregnancy ideal body weight, AOR 4.65). Risk factors among women in Northern Nigeria are similar to those reported from other studies. Good antenatal cares, early detection, reduction of stressful conditions at home are the most important preventive measures of early-onset severe PE among these women.

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“…According to the National Health And Nutrition Examination Survey (NHANES), at least 65 million adult Americans, or nearly one-third of the US adult population, have hypertension, defined as a systolic blood pressure Ն140 mm Hg, diastolic blood pressure Ն90 mm Hg, and/or current use of antihypertensive medication. 3 Another one-quarter of US adults have blood pressure in the "prehypertension" range, a systolic blood pressure of 120 to 139 mm Hg or diastolic blood pressure of 80 to 89 mm Hg, ie, a level above normal yet below the hypertensive range. 4 The prevalence of hypertension rises progressively with age, such that more than half of all Americans aged 65 years or older have hypertension.…”

Section: Epidemiology Of Hypertension Overviewmentioning

confidence: 99%

Recommendations for Blood Pressure Measurement in Humans and Experimental Animals

Pickering¹,

Hall²,

Appel³

et al. 2005

Hypertension

2,024

963

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Abstract-Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure-related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance.

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The prevalence and clinical significance of nocturnal hypertension in pregnancy

Cited by 60 publications

References 13 publications

Melatonin secretion is impaired in women with preeclampsia and an abnormal circadian blood pressure rhythm

Melatonin secretion is impaired in women with preeclampsia and an abnormal circadian blood pressure rhythm

Risk factors for pre-eclampsia among women at antenatal booking in Kano, Northern Nigeria

Recommendations for Blood Pressure Measurement in Humans and Experimental Animals

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