期刊
JOURNAL OF HYPERTENSION
卷 37, 期 1, 页码 182-186出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HJH.0000000000001848
关键词
ambulatory blood pressure; eclampsia; high-risk pregnancy; nocturnal hypertension; preeclampsia
资金
- Argentinian Society of Hypertension (SAHA)
Objective: The aim of this study was to test if hypertension detected by ambulatory blood pressure monitoring (ABPM) performed at mid-pregnancy, is a useful predictor for preeclampsia/eclampsia (PEEC). Methods: The study was performed in women coursing high-risk mid-pregnancies. Office blood pressure (BP) was estimated as the mean of three values, taken by a specialized nurse after a 15-min interview, and office hypertension defined as at least 140/90 mmHg. Immediately after, an ABPM was started. Diurnal hypertension was defined as ABPM at least 135/85mmHg during daily activities, nocturnal hypertension as ABPM at least 120/70mmHg during night rest. The adjusted risk of PEEC was estimated using logistic regression. Results: Eighty-seven women (mean age 31 +/- 7 years) with 23 +/- 2 weeks of pregnancy were included. The prevalence of office and ABPM hypertension was 13.8 and 40.2%, respectively. The concordance between both hypertension diagnosis was low (kappa = 0.170, P = 0.044). Nocturnal hypertension (35.6%) was more frequent than diurnal hypertension (26.4%). Nocturnal hypertension markedly increased the relative risk of PEEC (OR 5.32, 95% CI 1.48-19.10). The risk of PEEC attributed to diurnal hypertension did not reach statistical significance; and when both, diurnal and nocturnal hypertension were included in the same model, only the second one was a significant predictor (P = 0.012). The relative risk associated with nocturnal hypertension increased for women not taking acetylsalicylic acid (ASA); (OR 11.40, 95% CI 2.35-55.25). Conclusion: Nocturnal hypertension at high-risk midpregnancy is a frequent condition and a strong predictor for PEEC; the risk doubled for women not taking ASA.
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