Blood-pressure variability is associated with left-ventricular mechanics in patients with gestational hypertension and preeclampsia.

Abstract

We aimed to investigate short- and long-term blood-pressure (BP) variability and left-ventricular (LV) structure, function, and mechanics in women with gestational hypertension and preeclampsia, as well as the relationship between BP variability and LV mechanics. This cross-sectional study included 140 pregnant women (45 normotensive controls, 50 patients with gestational hypertension and, 45 patients with preeclampsia) after 20 weeks of gestation. All participants underwent 24-h ambulatory BP monitoring and echocardiographic examination, as well as regular clinical BP measurements during each visit. Our results show that 24-h, daytime and nighttime systolic and diastolic BP, as well as visit-to-visit systolic and diastolic BPs, gradually increased from controls across patients with preeclampsia to those with gestational hypertension. Similar changes were observed for 24-h systolic BP-variability indices. LV longitudinal and circumferential strains gradually decreased from controls across women with gestational hypertension to patients with preeclampsia. Radial strain was significantly lower in women with preeclampsia than in controls. Indices of short- and long-term BP variability were independent of BP and demographic and echocardiographic parameters associated with LV longitudinal and circumferential strain. In conclusion, LV mechanics are impaired in women with gestational hypertension and preeclampsia compared with LV mechanics in normotensive controls. Short- and long-term BP variability was higher in patients with hypertensive disorders and was significantly associated with longitudinal and circumferential strains.