Blood Pressure Levels In Women Research Articles

Perinatal Outcome and Its Association with Blood Pressure Levels in Women with Preeclampsia.

Timing and mode of delivery in women with preeclampsia remains challenging, often balancing the risk of severe maternal complications and preterm delivery with its risks for the newborn. It is known that women with very high blood pressure levels in pregnancy have more unfavourable outcomes, but there is little data on neonatal outcome in these cases and the effect of the delivery mode. We included 158 preeclamptic women in our single-centre retrospective cohort study. Patients were divided into three subgroups depending on blood pressure levels, and delivery mode as well as neonatal outcomes were analysed. Furthermore, the effect of gestational age at delivery was assessed. Maternal blood pressure levels correlated negatively with gestational age at delivery (p = 0.007) and positively with delivery via caesarean section (p = 0.003). Induction of labour was more frequent in women with lower blood pressure levels (p = 0.008) and higher gestational age (p < 0.001). If labour was induced, vaginal delivery was achieved equally often in all gestational ages. Neonatal outcome appears to be more favourable after vaginal delivery compared to planned caesarean section (p < 0.001). Induction of labour should be discussed generously in preeclamptic women, even if blood pressure levels are high and/or gestational age is young, as success rates seem to be adequate and neonatal outcome is more favourable after vaginal delivery. Large prospective trials are needed to better evaluate success rates, risks and complications of induced labour and the effects of delivery mode on neonatal outcome in preeclampsia.

Factors, associated with effective control of arterial hypertension in the general working-age population

Objective. To analyze determinants and their contribution to efficiency of arterial hypertension (AH) control in the hypertensive population.Design and methods. In the cross-sectional study a total of 334 men and 436 women derived from a representative sample of the general population aged 25–64 years, meeting criteria for AH, were examined. All subjects signed voluntary informed consent to participate in the study. A standard questionnaire based on adapted international methods was used. The associative analysis included sets of socioeconomic, behavioral, psychosocial, medical and biological variables. We used univariable (χ2, Fisher exact test, Student’s t-test, Mann–Whitney test) and multivariable statistics (logistic regression). Effective AH control was considered in case of blood pressure (BP) < 140/90 mm Hg. Probabilities of error < 5% were considered statistically significant.Results. Irrespective of gender, use of hypotensive drugs was the most influential factor in ensuring effective control of AH in the population. A major barrier to reaching target BP levels in women was the number of current metabolic risk factors (RF). Age (more significant in men), general obesity (both sexes), history of kidney disease (men), elevated glucose and triglycerides (women) were also associated with ineffective AH control. Angiotensine receptor blockers, angiotensin converting enzyme inhibitors (ACEI), sympatholytics/ spasmolythics in men and ACEI, beta-blockers and diuretics (at moderate or higher affluence only) in women were associated with a higher probability of reaching BP targets. Knowledge of cholesterol level (both sexes), cardiovascular disease, use of statins, reduced quality of life (difficulty with daily activities), sedentary working activity and affluence in men were also associated with effective control of BP.Conclusions. The data obtained demonstrate that with an increase in the coverage of the hypertensive population with antihypertensive treatment, an increase in the proportion of people reaching the target BP levels may be significant, but still the most important issue is the treatment efficiency. The need to correct behavioral factors that lead to the development of metabolic disorders, especially obesity, but also other RF, remains the most challenging issue in this regard. The findings convince us that it is advisable to take measures to increase awareness of the main cardiovascular disease RF, to involve patients more in controlling their RF, to prescribe statins more frequently, to create conditions for taking antihypertensive drugs in the so-called “mobile” types of working activity, to keep developing infrastructure for mass participation of population in sport activities, and to improve economic conditions.

The effect of garlic (Allium sativum) supplementation on the lipid parameters and blood pressure levels in women with polycystic ovary syndrome: A randomized controlled trial.

Polycystic ovary syndrome (PCOS) is the most prevalent female endocrine-related disorder in reproductive ages. The aim of the study was to investigate the effect of garlic on the lipid parameters and blood pressure levels in women with PCOS. The present study was a randomized, double-blinded control trial, conducted on 80 PCOS patients. Participants were taught to intake either a total 800 mg/day garlic supplement or an identical placebo (starch) after lunch for 8 weeks. Physical activity, diet intake, anthropometric measures, and blood pressure were evaluated at baseline and end of the study. The blood sample was also taken to assess the change in outcomes of interest at the pre- and post-intervention. Garlic supplementation significantly reduced serum total cholesterol (change mean difference: -8.05, 95% CI: -15.47, -0.62) and LDL-C (change mean difference: -7.67, 95%CI: -14.64, -0.70) levels in comparison to the control group. In addition, a trend to a significant decrease was found in serum triglyceride levels and Systolic blood pressure; however, no significant difference was observed between two groups in HDL-C and diastolic blood pressure levels. The present study suggested that garlic supplementation might be effective on lipid markers improvement. Further studies are needed to confirm our findings.

1387-P: Risk of Perinatal Complications across Gestational Blood Pressure Levels in Women with and without Gestational Diabetes (GDM)

Hypertensive disorders in pregnancy and GDM are among the leading causes of maternal and perinatal morbidity. In 2017, the American College of Cardiology/American Heart Association released a new guideline for hypertension: systolic/diastolic blood pressure (SBP/DBP) ≥130/80 vs. previous 140/90 mmHg. However, these new cut-points have not been applied to pregnant women due to the lack of evidence on its impact on perinatal outcomes. We examined in women with and without GDM whether the risk of perinatal complications increased across SBP/DBP levels: normal (<120/80 mmHg, untreated), elevated (120-129/<80, untreated), stage 1 gestational hypertension (GH, 130-139/80-89, untreated), and stage 2 GH (≥140/90, treated or untreated). The study was conducted in 2017-2018 among 6458 women with GDM and 50885 without GDM, who were Kaiser Permanente Northern California members without pre-existing hypertension. Logistic regression examined associations of BP categories with perinatal outcomes, adjusting for sociodemographic, medical, and lifestyle covariates. The prevalences were higher in women with vs. without GDM: elevated BP 21.3% vs. 20.0%, stage 1 GH 18.6 % vs. 16.1%, and stage 2 GH 3.6% vs. 2.6% (all P <0.05). Associations with risk of large-for-gestational age were more pronounced among women with vs. without GDM, with adjusted odds ratios (OR) for elevated BP of 1.54 (95% CI 1.28-1.84) vs. 1.22 (1.13-1.31) and for stage 1 GH of 1.35 (1.11-1.64) vs. 1.21 (1.11-1.31) (P for interaction <0.01). Associations with preterm birth and small-for-gestational age were present only for stage 2 GH among women without GDM: OR 1.56 (1.26-1.91) and 1.59 (1.34-1.88), respectively (P for interaction=0.02 and 0.08, respectively). Although GH was more common in women with GDM, its associations with perinatal complications varied by GDM status. Also, our findings suggest the new guideline may identify women with subclinical high BP in pregnancy at risk of perinatal complications. Disclosure Y. Zhu: None. J. Feng: None. A. Ngo: None. C. Quesenberry: None. A. Ferrara: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (K01DK120807)

Blood pressure and hemodynamics: Mayer waves in different phases of ovarian and menstrual cycle in women.

The goal of the research is to investigate the special effect of ovarian-menstrual cycle phases on the level of women's blood pressure and characteristics of Mayer waves. 77 women aged 18-19 were tested under condition close to the state of basal metabolism in follicular phase (I), ovulation (II) and luteal phase (III) of ovarian-menstrual cycle. In phases II and III, the increase of mean and diastolic blood pressure level, in comparison with phase I in the prone position at rest and with psycho-emotional loading, were observed. The distinctions between variation parameters of R-R interval duration, stroke volume and its synchronization in phases II and III, in comparison with phase I, were observed in the prone position at rest, during tilt-test and with psycho-emotional loading. The substantial level of relationship between the power of Mayer waves and mean and diastolic blood pressure, mainly in phase I under conditions of all types, is observed. The maximum peak amplitude of stroke volume spectrogram is associated with pressure levels in the range of 0.04-0.15 Hz (rho from -0.33 to -0.64). The obtained results indicate the possible participation of spontaneous baroreflex sensitivity characteristics in keeping blood pressure level in women.

Abstract MP41: Health-related Quality of Life and Risk of Hypertension in the Community: A Prospective Analysis from the Western New York Health Study

Health-related Quality of Life and Risk of Hypertension in the Community: A Prospective Analysis from the Western New York Health Study Background: Measures of quality of life and health status are strong predictors of mortality and morbidity outcomes including cardiovascular disease (CVD). However, prospective epidemiological evidence from population-based studies on the potential impact of these measures on hypertension risk is scant. Objective: We sought to examine the independent role of measures of quality of life and health status on the risk of incident hypertension in a community-based sample from Western New York. Methods: A longitudinal analysis, over 6 years of follow-up, among 946 women and men (mean age 54.3 years) from the community, who were free of hypertension, CVD, and diabetes at the baseline examination, in the Western New York Health Study (WNYHS). Baseline variables included socio-demographics, anthropometrics, blood pressure, biomarker data, major behavioural risk factors, and measures of quality of life and health status, such as the physical and mental health component summaries of the short form-36 questionnaire (SF-36). Incident hypertension was defined as blood pressure > or =140/90 or on antihypertensive medication at the follow-up visit. Results: The cumulative six year incidence of hypertension was 22.6% (214/942). In bivariate analyses, there were several baseline correlates of incident hypertension, including age, BMI, and baseline blood pressure levels in both sexes; whereas cigarette smoking, change in BMI, family history of hypertension, and the SF-36 physical score were all significantly associated with hypertension only among women. After multivariate adjustment, cigarette use at baseline (OR: 2.96, 1.35, 6.51), family history of hypertension (OR: 2.59, 1.52-4.42), BMI change since baseline (OR: 1.18, 1.06-1.31), and the SF-36 physical score (OR: 0.97, 0.94-0.99 for a unit change) were the only significant predictors of hypertension independent of age and baseline blood pressure levels in women. Conclusions: Results from this study suggest that measures of health-related quality of life may represent independent predictors of hypertension risk, at least among women, above and beyond the role of traditional risk factors, such as age, smoking, body weight, and familial predisposition.

614: Pregnancy outcome vary by blood pressure level in women with mild-range chronic hypertension

614: Pregnancy outcome vary by blood pressure level in women with mild-range chronic hypertension

Sex Differences in Hypertension: Contribution of the Renin–Angiotensin System

Numerous studies have shown that female human beings exhibit lower blood pressure levels over much of their life span compared with their age-matched counterparts. This sexual dimorphism is apparent in human beings as well as most, if not all, mammals. However, after the onset of menopause blood pressure levels in women increase and become similar to those in men, suggesting an important role of sex hormones in the regulation of blood pressure. The lower blood pressure levels in premenopausal women are associated with a lower risk of development and progression of cardiovascular disease and hypertension compared with age-matched men. This clear female advantage with respect to lower incidence of cardiovascular disease no longer exists after menopause, again highlighting the importance of sex hormones in the pathophysiology of cardiovascular disease in both men and women. In fact, both estrogens and androgens have been implicated in the development of cardiovascular disease and hypertension, with estrogens, in general, being protective and androgens being detrimental. Although the exact mechanisms by which sex hormones contribute to the regulation of cardiovascular function and blood pressure are still being investigated, there is increasing evidence that modulating the activity of locally active hormonal systems is one of the major mechanisms of sex hormone actions in target organs, including the vasculature and kidneys. Indeed, several studies have demonstrated the importance of the interaction between sex hormones and the renin-angiotensin system in regulating cardiovascular function and blood pressure. Furthermore, the differential effects of estrogens and androgens on the expression and activity of the components of the renin-angiotensin system could possibly explain the sex differences in blood pressure levels and the development and progression of cardiovascular disease and hypertension.

Knowledge of hypertensive disorders in pregnancy among obstetricians and midwives

BackgroundHypertension in pregnancy remains one of the leading causes of maternal deaths in the UK and is associated with an increased lifetime risk of cardiovascular disease.MethodsAn anonymous structured questionnaire, based...

HYPERTENSIVE PREGNANCIES– A 35 YEAR FOLLOW-UP ON CARDIOVASCULAR REGULATION – IS THE SYMPATHETIC ACTIVATION STILL PERSISTENT?: 9C.07

Objective: Gestational hypertension is associated with an increased risk of developing primary hypertension later in life and preeclampsia has been shown to increase the risk of coronary artery disease. Preeclampsia is a condition associated with sympathetic over activity, which in turn, is thought to constitute a precursor of preeclampsia and hence cause hypertension. Whether the increased sympathetic drive in hypertensive pregnancies persists following delivery is however not known. The aim of the present study was to investigate sympathetic nerve activity and blood pressure level in women with hypertensive pregnancies (HP), 35 years following delivery. Design and Methods: Sympathetic nerve activity was recorded in 25 women with prior a) HP and present diagnosis of hypertension, b) HP without present diagnosis of hypertension and c) normotensive pregnancies, without present diagnosis of hypertension, serving as controls. Sympathetic nerve activity (MSNA) was expressed as burst frequency (BF), burst incidence (BI), relative median burst amplitude (MA%). Baroreflex slopes were determined by the relation between MSNA burst amplitude and corresponding diastolic blood pressure value. All subjects were investigated without withdrawal of ongoing medication. Results: The study groups were equal in terms of age, body mass index, heart rate and blood pressure level. MSNA BF, BI were however, significantly higher in the patient group with present hypertension as compared to the control (p = 0.02 for both) and patient group without hypertension (p = 0.04 and 0.01, respectively), whereas MSNA MA% did not differ. Baroreflex slopes were positively related to MSNA BF and BI (r = 0.5, p = 0.1, for both) for the whole study group. Conclusions: Our results show, that women with hypertensive pregnancies 35 years ago, still suffering from hypertension, have a persistent sympathetic activation despite ongoing antihypertensive medication. The difference in sympathetic outflow in this study can not be explained by differences in blood pressure level, since they did not deviate between the study groups.

Blood pressure levels in women with androgenetic alopecia

Blood pressure levels in women with androgenetic alopecia

Haemostatic, Endothelial and Lipoprotein Parameters and Blood Pressure Levels in Women with a History of Preeclampsia

To determine whether perturbations of haemostatic function and lipoprotein metabolism prevail long after preeclampsia and increase the risk of future coronary heart disease (CHD), we conducted a follow-up study in women with (cases, n = 25) or without (controls, n = 24) a history of preeclampsia. Blood samples were taken in the follicular and in the luteal phases of a menstrual cycle. Levels of blood pressure (BP) and proteinuria measured during the index pregnancy were included in the evaluation. Compared to control women who had undergone a normal pregnancy, the formerly preeclamptic patients had higher systolic (p <0.01) and diastolic (p <0.05) BPs and increased plasma levels of von Willebrand factor (vWF), fibrinogen, cholesterol, triglycerides and very low density lipoprotein (VLDL) (all p <0.05). The lipid, vWF, and fibrinogen levels were positively related to the degree of BP elevation but not to the degree of proteinuria during the index pregnancy. Except for the increase in vWF level, all biochemical perturbations were only present in the luteal but not in the follicular phase samples. In conclusion, persistent endothelial dysfunction with ensuing dysregulation of blood pressure, haemostatic perturbation and dyslipoproteinemia after preeclampsia may indicate a proneness to future CHD.

Coping and Appraisal of Daily Stressors Predict Heart Rate and Blood Pressure Levels in Young Women

An anger-provocation paradigm was used to assess the effects of coping processes and appraisal of daily stressors on stress reactivity in 33 normotensive undergraduate women. Participants performed a mental arithmetic and an interpersonal conflict task during the pre- and postmenstrual phases of their menstrual cycles. Increased use of the emotion-focused coping processes of tension reduction and positive reappraisal was correlated with lower levels of baseline heart rate, whereas distancing was associated with higher levels of systolic blood pressure reactivity during the conflict task. Perceiving daily stressors as more stressful was associated with higher baseline diastolic blood pressure levels. The authors concluded that the transactional model of stress is useful for generating hypotheses about factors that predict heart rate and blood pressure levels in women.