Blood pressure variability in pregnant women with risk factors of preeclempsia

Abstract


Aim. To assess the short-term and long-term variability of blood pressure in women, starting from early pregnancy, to predict the development of complications of gestation, including preeclempsia.

Methods. In 131 pregnant women, systolic blood pressure, diastolic blood pressure, as well as short-term (intra-visit) and long-term (inter-visit) blood pressure variability were assessed during the gestation period and 6 weeks after delivery. At the end of gestation period, depending on the identified complications, all study participants were divided into four groups: group 1 - control (healthy); group 2 - pregnant with preeclempsia; group 3 - with placental insufficiency; group 4 - with chronic arterial hypertension. In patients with placental insufficiency the indices of fetal growth retardation were also analyzed.

Results. In group 4, starting from the second trimester, higher values of short-term blood pressure variability were demonstrated, which increased as pregnancy progressed. Long-term blood pressure variability increased in groups 2 and 4, starting from the second trimester. In pregnant women with fetal growth retardation in the first trimester, blood pressure variability was higher than in pregnant controls and in the second trimester it was higher than in the group with the subsequent development of preeclempsia. Thus, during pregnancy complicated by preeclempsia or placental insufficiency with fetal growth retardation, high long-term blood pressure variability was observed. At the same time, the highest values were observed in the third trimester.

Conclusion. The assessment of long-term blood pressure variability from the early gestation seems to be an effective tool for detecting preclinical changes in the body of a pregnant woman, preceding the development of preeclempsia and fetal growth retardation, and in the presence of risk factors of preeclampsia allows narrowing the group of patients for target follow-up and prevention.


S D Mayanskaya

Kazan State Medical University

Author for correspondence.
Email: Smayanskaya@mail.ru

Russian Federation, Kazan, Russia

A V Ganeeva

Kazan State Medical University

Email: Smayanskaya@mail.ru
Kazan State Medical University

R I Gabidullina

Kazan State Medical University

Email: Smayanskaya@mail.ru
Kazan, Russia

  1. Makarov O.V., Volkova E.V., Dzhokhadze L.S. Prospects for diagnosis and prediction of pre-eclampsia. Rossiyskiy vestnik akushera-ginekologa. 2012; 12 (1): ­35–42. (In Russ.)
  2. Dolgushina V.F., Chulkov V.S., Vereina N.K. et al. Obstetric complications in various forms of hypertension in pregnant women. Akusherstvo i ginekologiya. 2013; (10): 33–39. (In Russ.)
  3. Serov V.N. Prevention of maternal mortality. Akusherstvo i ginekologiya. 2011; (7-1): 4–10. (In Russ.)
  4. Whitehouse A., Robinson M., Newnham J., Pennell C.D. Hypertensive diseases of pregnancy disrupt neurocognitive development in offspring? Pediatric and Perinatal Epidemiol. 2012; 26 (2): 101–108. doi: 10.1111/j.1365-3016.2011.01257.
  5. Sidorova I.S., Nikitin N.A., Una­nyan A.L. et al. Pathogenetic rationale for a differentiated approach to the management of pregnant women with arterial hypertension and preeclampsia. Akusherstvo i ginekologiya. 2013; (2): 35–40. (In Russ.)
  6. Ostroumova O.D. Long-term blood pressure variability is a new «target» for antihypertensive the­rapy. Are there any differences between β-blockers? Kar­diologiya. 2012; 52 (10): 58–64. (In Russ.)
  7. Giuseppe M., Bombelli М., Facchetti R. et al. Long-term prognostic value of blood pressure variability in the general population. Results of the Pressioni Arte­riose Monitorate e Loro Associazioni Study. Hypertension. 2007; 49: 1265–1270. doi: 10.1161/HYPERTENSIONAHA.107.088708.
  8. Munter P., Schimbo D., Tonelli M. et al. The relationship between visit-to-visit variability in systolic blood pressure and all-cause mortality in the General population. Hypertension. 2011; 57: 160–166. doi: 10.1161/HYPERTENSIONAHA.110.162255.
  9. Stryuk R.I., Bu­nin Yu.A., Gur'eva V.M. et al. Diagnosis and treatment of cardiovascular diseases during pregnancy. Сli­nical guidelines. Rossiyskiy kardiologicheskiy zhurnal. 2018; 23 (3): 91–134. (In Russ.)
  10. NICE Guidelines 2011. Hypertension: management of hypertension in adults in primary care. http://www.nice.org.uk/CG127 (access date: 03.02.2019).
  11. Rothwell P.M. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet. 2010; 375 (9718): 895–905. doi: 10.1016/S0140-6736(10)60308-X.
  12. Voss A., Malberg H., Schumann A. et al. Baroreflex sensitivity, heart rate, and blood pressure variability in normal pregnancy. AJH. 2000; 13: 1218–1225. doi: 10.1016/S0895-7061(00)01199-7.

Views

Abstract - 52

PDF (Russian) - 68

Cited-By


PlumX


© 2019 Mayanskaya S.D., Ganeeva A.V., Gabidullina R.I.

Creative Commons License

This work is licensed
under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.


Свидетельство о регистрации СМИ ЭЛ № ФС 77-75008 от 1 февраля 2019 года выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор)