ARTERIAL HYPERTENSION IN PREGNANCY - PULSE WAVE VELOCITY EVALUATION AS A PROGNOSTIC MARKER

Abstract

Objective: In the general population, arterial stiffness is associated with a higher incidence of cardiovascular complications. Little is known whether this same trend is observed in pregnant women with hypertension. The authors presented in 2020, a series of 234 pregnant women complicated by arterial hypertension submitted to 24-hour ambulatory monitoring (ABPM). They concluded that the absence of nocturnal pressure drop, especially diastolic pressure, was associated with a worse maternal-fetal outcome. The aim of this work is to present preliminary results of PWV in pregnant women with hypertension, and its relationship with an aggravated maternal-fetal outcome, as well as its relationship with the findings previously obtained with ABPM. Design and method: Observational study of 22 pregnant women who underwent VOP (Complior Analyze) and ABPM (Spacelabs 90207), between July 2015 and July 2022. Event was defined by: maternal death, fetal or neonatal death, preeclampsia or eclampsia, gestational diabetes, prematurity, fetal growth retardation, or dystocia due to uncontrolled hypertension. Results: The mean age and BMI were 31.0 ± 6.0 years and 27.2 ± 4.3 kg/m2. PWV showed mean values of 6.2 ± 0.9 m/s, and ABPM values for the studied population, SBP 24h 117.8 ± 8.6mmHg; DBP 24h 73.3 ± 8.8 mmHg; daytime SBP 123.8 ± 8.5 mmHg; daytime DBP 78.4 ± 7.9 mmHg; nocturnal SBP 106.9 ± 9.7mmHg; Night DBP 63.4 ± 9.2 mmHg. Pearson's correlation coefficient was calculated to measure the linear correlation between the variables and a hypothesis test was performed to conclude on the hypothesis of correlation between the variables. Analysis with Pearson's correlation showed a negative correlation between PWV values and nocturnal DBP and SBP decreases in percentage, which infers that nocturnal decrease values decrease when PWV values increase. In the case of the correlation between PWV and nocturnal SBP decrease, the correlation coefficient was -0.495 (p = 0.016). In the case of the correlation between PWV and nocturnal fall in DBP, the correlation coefficient was -0.425 (p = 0.043). Conclusions: In line with what was previously demonstrated, the results suggest that a higher PWV, pathophysiological related to alterations in vessel elasticity, pro-inflammatory status