75 Central blood pressure and arterial stiffness in various forms of hypertension in pregnancy

Abstract

Introduction Arterial stiffness and central pressure measurements should be considered as recommended tests for the evaluation of cardiovascular risk in general population, whereas in pregnancy, their meaningfulness is not established. The estimation of these parameters for early detection of preeclampsia may be helpful. Objectives To evaluate the central (aortic) blood pressure (BP) and arterial stiffness in women with various forms of hypertension and their prognostic role in development of preeclampsia (PE). Methods In a prospective cohort study there were included 300 pregnant women: 106 – with chronic hypertension (CH) – group 1; 63 – with gestational hypertension (GH) – group 2; 10 – with PE – group 3; 21 – with preeclampsia superimposed on chronic hypertension (CH+PE) – group 4 and 100 – without hypertension (comparison group) – group 5. Ambulatory BP monitoring oscillometric measurement method with the definition of the central (aortic) BP and arterial stiffness parameters (augmentation index, reflected wave transit time, arterial stiffness index) in 16–22 weeks of pregnancy was performed in all patients using a 24–h BP monitoring system, ie, BPLab® and Vasotens® technology (Petr Telegin, Nizhny Novgorod, Russian Federation). Statistical analysis was performed using the statistical software package MedCalc®, version 11.5.0 (Mann–Whitney test, Kruskal–Wallis test, Pearson’s chi-squared test, logistic regression analysis, ROC-analysis). Statistical significance was considered to be a p Results The average peripheral (brachial) systolic blood pressure (SBP) 24 h was higher in all pregnant women with hypertension: with CH (130 ± 8.8 mmHg), with GAG (136 ± 6.9 mm Hg), with PE (136 ± 6.9 mmHg), with PE superimposed on CH (138 ± 7.9 mmHg) vs comparison group (118 ± 5.1 mmHg p1,2,3,4-5 Conclusions 24-h blood pressure monitoring in pregnant women with hypertension in 16–22 weeks of gestation may be useful to obtain additional information about central SBP and arterial stiffness as a prognostic parameters for prediction of preeclampsia.