Blood Pressure In Pregnant Women Research Articles

EFFECTIVENESS OF LAVENDER AROMATHERAPY AND CLASSICAL MUSIC THERAPY IN LOWERING BLOOD PRESSURE IN PREGNANT WOMEN WITH HYPERTENSION

Background: Hypertension during pregnancy remains high in Indonesia. It is a major cause of maternal death. Aromatherapy lavender and classical music therapy are considered effective in lowering blood pressure in hypertension.
 Objective: To examine the effect of lavender aromatherapy and classical music therapy in lowering blood pressure in pregnant women with hypertension.
 Methods: A quasi-experimental study with pretest-posttest control group design. There were 52 pregnant women selected using simple random sampling, divided into lavender aromatherapy group, classical music group, combination of aromatherapy and music group, and control group. Sphygmomanometer was used to measure blood pressure. Mann Whitney and Post Hoc test were used for data analysis.
 Results: Results showed that four groups had a significant decrease in systolic blood pressure after given intervention with p-value <0.05. The mean decrease of systolic blood pressure among four groups was: lavender group (5.77 mmHg), music group (7.23 mmHg), combination group (9.54 mmHg), and control group (3.67 mmHg); and the mean decrease of diastolic blood pressure was: the lavender group (2.77 mmHg), music group (0.61 mmHg), combination group (8.23 mmHg), and control group (3.42 mmHg).
 Conclusion: There was a significant effect of lavender aromatherapy and classical music therapy in lowering blood pressure in pregnant women with hypertension. However, the combination of both interventions was more effective than lavender aromatherapy or music therapy alone.

EFFECT OF CONSUMING TOMATO (LYCOPERSIUM COMMUNE) JUICE IN LOWERING BLOOD PRESSURE IN PREGNANT MOTHERS WITH HYPERTENSION

Background: High blood pressure during pregnancy can pose significant problems such as preeclampsia, eclampsia, and premature birth. Thus, early prevention is needed. Consuming tomato (lycopersium commune) juice is considered effective to reduce blood pressure in pregnant women.
 Objective: This study aims to examine the effect of tomato juice on the decrease in blood pressure of pregnant women with hypertension in pregnancy.
 Methods: This study was a quasi-experiment with pretest-posttest control group. This research was conducted at the working area of the Community Health Center of Magelang Indonesia in July 2016 - January 2017. The target population of this study was pregnant women in trimester I, II, and III with high blood pressure. There were 30 samples selected using consecutive sampling, with 15 assigned in the experiment and control group. Wilcoxon test was performed for data analysis.
 Results: There was a statistically significant difference in systolic and diastolic blood pressure before and after given tomato juice with p = 0.001 (<0.05).
 Conclusion: Consuming tomato juice can be one of the efforts to reduce blood pressure in pregnant women with hypertension.

Effect of Egg Whites on Decreasing Blood Pressure in Pregnant Women with Hypertension

Effect of Egg Whites on Decreasing Blood Pressure in Pregnant Women with Hypertension

Ventricular dyssynchrony in pregnant women: A tissue Doppler study.

The aim of the study was to assess the left ventricular (LV) synchronicity in pregnant women and to identify the main determinants of LV dyssynchrony in asymptomatic pregnant women. One hundred sixty-seven pregnant women consecutively and 48 age-matched nonpregnant controls were enrolled. For the assessment of LV systolic dyssynchrony, the standard deviation of the time from QRS onset to peak systolic (Tps-LV- standard deviation [SD]) velocity and the maximal difference of the time from QRS onset to peak systolic velocity (Tps-LV) from 12 segments at the apical views. For the LV diastolic dyssynchrony, the standard deviation of the time from QRS onset to peak diastolic (Tpe-LV-SD) velocity and the maximal difference of the time from QRS onset to peak diastolic velocity (Tpe-LV) were calculated. Both systolic and diastolic dyssynchrony indexes were significantly higher in pregnant women than in the normal controls (Tps-LV; P<.01, Tps-LV-SD; P<.03, Tpe-LV, P<.05 and Tpe-LV-SD; P<.02). A total of 28 (16.8%) of the pregnant women had a dyssynchrony index above the accepted value for LV dyssynchrony (>34.4msec). There was a significant correlation between LV dyssynchrony indexes with, multiparty, multifetal pregnancies, systolic blood pressure in pregnant women with LV dyssynchrony. Additionally LV dyssynchrony was significantly associated with elevated E/e" and brain natriuretic peptide (BNP). Both systolic synchronicity and diastolic synchronicity were affected in pregnant women compared to nonpregnant women. LV dyssynchrony was significantly correlated with age, multiparity, and BNP level. Early detectable changes in systolic and diastolic synchrony may be present in pregnant women at higher risk of peripartum cardiomyopathy.

Longitudinal Patterns of Glycemic Control and Blood Pressure in Pregnant Women with Type 1 Diabetes Mellitus: Phenotypes from Functional Data Analysis

Objective To identify phenotypes of type 1 diabetes control and associations with maternal/neonatal characteristics based on blood pressure (BP), glucose, and insulin curves during gestation, using a novel functional data analysis approach that accounts for sparse longitudinal patterns of medical monitoring during pregnancy. Methods We performed a retrospective longitudinal cohort study of women with type 1 diabetes whose BP, glucose, and insulin requirements were monitored throughout gestation as part of a program-project grant. Scores from sparse functional principal component analysis (fPCA) were used to classify gestational profiles according to the degree of control for each monitored measure. Phenotypes created using fPCA were compared with respect to maternal and neonatal characteristics and outcome. Results Most of the gestational profile variation in the monitored measures was explained by the first principal component (82-94%). Profiles clustered into three subgroups of high, moderate, or low heterogeneity, relative to the overall mean response. Phenotypes were associated with baseline characteristics, longitudinal changes in glycohemoglobin A1 and weight, and to pregnancy-related outcomes. Conclusion Three distinct longitudinal patterns of glucose, insulin, and BP control were found. By identifying these phenotypes, interventions can be targeted for subgroups at highest risk for compromised outcome, to optimize diabetes management during pregnancy.

Drinking Water Sodium and Elevated Blood Pressure of Healthy Pregnant Women in Salinity-Affected Coastal Areas.

Coastal areas in Southeast Asia are experiencing high sodium concentrations in drinking water sources that are commonly consumed by local populations. Salinity problems caused by episodic cyclones and subsequent seawater inundations are likely (partly) related to climate change and further exacerbated by changes in upstream river flow and local land-use activities. Dietary (food) sodium plays an important role in the global burden of hypertensive disease. It remains unknown, however, if sodium in drinking water-rather than food-has similar effects on blood pressure and disease risk. In this study, we examined the effect of drinking water sodium on blood pressure of pregnant women: increases in blood pressure in this group could severely affect maternal and fetal health. Data on blood pressure, drinking water source, and personal, lifestyle, and environmental confounders was obtained from 701 normotensive pregnant women residing in coastal Bangladesh. Generalized linear mixed regression models were used to investigate association of systolic and diastolic blood pressure of these-otherwise healthy-women with their water source. After adjustment for confounders, drinkers of tube well and pond water (high saline sources) were found to have significantly higher average systolic (+4.85 and +3.62 mm Hg) and diastolic (+2.30 and +1.72 mm Hg) blood pressures than rainwater drinkers. Drinking water salinity problems are expected to exacerbate in the future, putting millions of coastal people-including pregnant women-at increased risk of hypertension and associated diseases. There is an urgent need to further explore the health risks associated to this understudied environmental health problem and feasibility of possible adaptation strategies.

778: Tight versus less tight control of blood pressure in pregnant women with chronic hypertension--a cost-effective analysis

778: Tight versus less tight control of blood pressure in pregnant women with chronic hypertension--a cost-effective analysis

PP.24.13

Objective: Blood pressure (BP) changes across pregnancy are well known. These changes were studied mainly by the BP measurement at brachial artery. Several guidelines on hypertension indicate good diagnostic characteristics of 24-h BP in pregnant women. In recent years the technique of non-invasive measurement of central aortic BP (BPao) was developed. Also 24-h BPao measurement technique appeared. Thus, the aim of our study is to assess the distribution of the 24-h BPao according to the gestational age. Design and method: Every trimester 40 non-complicated pregnant women were examined for 24-h sampling within a period from the first obstetric examination until delivery. 120 ABPM profiles (e.g. BPW-files) were assessed in total. Oscillometric BPLab system for monitoring BP and Vasotens technology to analyze brachial cuff blood pressure waves (BPW) and to obtain 24-h BPao and BPStat software to tabulate all BPW data were used. Descriptive statistics: median [25th, 75th percentiles] mmHg. Results: First trimester: total BPW-files – 40, awake systolic BPao – 104.0 [99.0, 106.0], asleep systolic BPao – 89.5 [87.0, 96.5]; second trimester: total BPW – 40, awake systolic BPao – 103.0 [96.5, 104.5], asleep systolic BPao – 88.0 [85.5, 91.5]; third trimester: total BPW – 40, awake systolic BPao – 107.0 [99.0, 111.0], asleep systolic BPao – 95.0 [92.0, 99.5] mmHg. Conclusions: Distribution of 24-h BPao according to the gestational age may be characterized by the tendency of BPao decreasing in second trimester and by increasing of BPao in third trimester. Diurnal BPao patterns were identified in pregnant women.

Temporal variation in the acute effects of air pollution on blood pressure measured at admission to labor/delivery

Same day or recent air pollution exposure increases blood pressure in pregnant women. Temporal blood pressure variation associated with hourly air pollution is unstudied. We randomly selected 500 women (249 normotensive, 191 with hypertensive disorders, and 60 with chronic hypertension) with singleton pregnancies and blood pressure measured at labor/delivery admission from a large cohort, the Consortium on Safe Labor. Community multiscale air quality models estimated hourly air pollutant exposures for the admission hour (lag 0) and for the 24 h preceding labor/delivery admission (lags 1–24). Linear regression estimated the effect of 10 % increase in pollutants on blood pressure at each time point, adjusting for maternal characteristics, labor type, and time of day. Women with chronic hypertension had higher systolic blood pressure with exposure to particulate matter <10 μm (by 1.0–1.3 mmHg at 0–4 h), sulfur dioxide (by 0.7–0.9 mmHg at 0–3, 16–20, and 22–23 h) and with some air toxics. Diastolic blood pressure was higher in normotensive women with ozone exposure (by 0.1–0.4 mmHg at 0–1 and 23–24 h). Similar effects for systolic blood pressure were seen among women with hypertensive disorders (by 0.6 mmHg at 19–20 h), but most pollutants were associated with lower blood pressure in these women. Substantial variation in the impact of hourly air pollutant measures on blood pressure was observed during the day prior to labor/delivery admission, both by mothers’ hypertensive status and by the lag time prior to BP measurement. Effects were largest near admission (lags 0–4) and among women with chronic hypertension.

Serum Vitamin D Insufficiency Is Related to Blood Pressure in Diabetic Pregnancy

Vitamin D deficiency in pregnancy has been associated with an increased risk of preeclampsia. However, the association between serum vitamin D and blood pressure in pregnant women has been scarcely evaluated, particularly in women with a high risk of developing hypertensive disorders of pregnancy. We sought to evaluate the association between serum 25-hydroxyvitamin D and blood pressure in pregnant women with gestational diabetes mellitus (GDM). A cohort of 184 pregnant women with GDM was followed during the third trimester of pregnancy and early puerperium. Blood pressure was recorded in all prenatal visits, and serum vitamin D was measured by chemiluminescence immunoassay. Pearson's coefficients and multiple linear regressions were used to study predictors of blood pressure levels. Women with vitamin D insufficiency (<30ng/mL; n = 159) had higher systolic and diastolic blood pressure than the remaining participants. In white women (n = 136), serum vitamin D levels presented a significant negative correlation with systolic blood pressure at the beginning (r = -0.268; P = 0.002) and at the end of the third trimester (r = -0.203; P = 0.02), and vitamin D significantly affected systolic blood pressure after adjusting for confounders. This was not observed in women of other ethnicities. In this cohort of pregnant women with GDM, vitamin D insufficiency was associated with higher blood pressure, and in white women, serum vitamin D was an independent predictor of systolic blood pressure during pregnancy.

Blood pressure and endothelial function in healthy, pregnant women after acute and daily consumption of flavanol-rich chocolate: a pilot, randomized controlled trial

BackgroundSeveral randomized clinical trials (RCTs) indicate that flavanol-rich chocolate has beneficial effects on flow-mediated dilation (FMD) and blood pressure (BP). However, no RCTs have evaluated these outcomes in pregnant women. The objective of this 2-group, parallel, double-blind RCT was to examine the effects of flavanol-rich chocolate on FMD and BP in pregnant women with normal BP.MethodsForty-four healthy, pregnant women were randomized to the high-flavanol (n = 23) or low-flavanol (n = 21) chocolate consumption for 12 weeks. At randomization (0, 60, 120 and 180 min after a single 40-g dose of chocolate), 6 and 12 weeks after daily 20-g chocolate intake, we evaluated plasma concentrations of flavanols and theobromine, as well as the FMD and BP.ResultsPlasma epicatechin was significantly increased (p < 0.001) 180 min after the consumption of 40-g high-flavanol chocolate compared to low-flavanol chocolate. Theobromine concentrations were significantly higher 180 min and 12 weeks after the intake of experimental chocolate or low-flavanol chocolate (p < 0.001). FMD was not different between the 2 groups at all pre-defined time periods. No other significant within-group or between-group changes were observed.ConclusionThese results confirm the feasibility of a large-scale RCT comparing daily consumption of flavanol-rich chocolate to an equivalent placebo during pregnancy and demonstrate higher plasma epicatechin and theobromine concentration in the intervention group after acute ingestionTrial registrationClinicalTrials.gov Identifier: NCT01659060

PP058. Cradle: Community blood pressure monitoring in rural Africa: Detection of underlying pre-eclampsia

In many developing countries pre-eclampsia is under-detected partly due to inadequate training in accurate blood pressure (BP) measurements and insufficient, poorly functioning equipment. To evaluate whether the introduction of easy to use, low cost novel BP devices (Microlife 3AS1-2; designed by our research group specifically for use in developing countries and validated in pregnancy (B/A grade) according to BHS criteria) into rural clinics in Tanzania, Zimbabwe and Zambia increases referrals for suspected pre-eclampsia to a central referral hospital (as reflected by an increase in mean BP in pregnant women seen in the central referral site). International prospective longitudinal pre- and post-intervention pilot study. BP measurements were taken from consecutive women ⩾20 weeks' gestation who accessed care at a referral site (N=694). 20 BP devices were distributed to 20 rural antenatal clinics in each country. Post-intervention data was collected the following year (N=547). After adjustment for confounders, there was a significant increase in primary outcome; post-intervention mean diastolic BP for all women (2.39mmHg, p<0.001, 95% CI 0.97-3.8), implying an increased proportion of referred hypertensive women; and a reduction in proportion of women (median gestation 35 weeks') who had never previously had a BP taken in pregnancy (25.1% to 16.9%, OR 0.58, p=0.001, CI 0.42-0.79). Equipping community healthcare providers with this novel validated BP device is feasible, widely accepted and results in increased referrals for suspected pre-eclampsia. A cluster RCT to evaluate the effect of these monitors equipped with a traffic-light 'early warning system' is planned.

PM.53 CRADLE: Community Blood Pressure Monitoring in Rural Africa: Detection of underLying Pre-Eclampsia

IntroductionIn developing countries pre-eclampsia is under-detected partly due to inadequate training in accurate blood pressure (BP) measurements and insufficient equipment. CRADLE is an international study to evaluate whether the introduction...

Selected polymorphisms of Renin-Angiotensin System in the pathology of hypertensive disorders of pregnancy

Pregnancy induced hypertension and pre-eclampsia, defined as hypertension and proteinuria after 20 weeks of pregnancy with no history of such symptoms, are a great challenge in the field of perinatology They are a serious threat to the mother and the child. Regardless of numerous studies on the subject, the pathogenesis of pregnancy-induced hypertension and pre-eclampsia is still unknown, although a crucial role of genetic factors combined with environmental factors has been confirmed. New theory based on genetic analysis of Renin-Angiotensin System and its impact on blood pressure in pregnant women, has been subject to much debate recently Numerous genes have been studied but angiotensinogen remains to be the best known. Little is known about angiotensin receptor type 1 and 2. This paper presents the knowledge about selected genes of RAS and their impact on pregnancy

Effect of l-Arginine Supplementation on Blood Pressure in Pregnant Women: A Meta-Analysis of Placebo-Controlled Trials

Objective. A meta-analysis of placebo-controlled trials was conducted to evaluate the effect of l-arginine supplementation on blood pressure (BP) in pregnancy. Methods. Trials were searched in PubMed, Embase, and Cochrane Library. A total of five trials were included in the meta-analysis. Results. l-Arginine supplementation exhibited a mean decrease of 3.07 mmHg (p = 0.004) for diastolic blood pressure and a mean increase of 1.23 weeks (p = 0.002) for gestation age at delivery in pregnancy, but did not reduce systolic BP (p = 0.19) as compared to placebo. Conclusion. l-Arginine supplementation had a significant effect of lowering diastolic blood pressure and prolonging gestation age in pregnancy.

Altered cardiovascular couplings of heart rate and blood pressure in pregnant women suffering from pre-eclampsia

Article Altered cardiovascular couplings of heart rate and blood pressure in pregnant women suffering from pre-eclampsia was published on August 30, 2012 in the journal Biomedical Engineering / Biomedizinische Technik (volume 57, issue SI-1-Track-F).

Androgen levels are associated with blood pressure in pregnant women after term

To assess possible associations between androgen, estrogen and insulin levels and blood pressure in pregnant women after term, compared with the effect of other well-known factors. Cross-sectional retrospective study. University Hospital, Trondheim region. Four hundred and eighty-nine post-term women with uncomplicated pregnancies. Blood pressure measurements and fasting serum samples drawn one week beyond the estimated day of delivery (defined as 41(+2) weeks). Blood pressure, maternal age, body mass index, parity, smoking habits and serum levels of dehydroepiandrosterone sulfate, androstendione, free testosterone index, estradiol, estriol, progesterone, 17-hydroxy-progesterone and insulin. In univariate linear regression analyses, body mass index, androstendione, free testosterone index and insulin were positively associated and parity was negatively associated with both systolic and diastolic blood pressure. In multivariate linear regression analyses, systolic blood pressure was positively associated with body mass index and free testosterone index, but negatively associated with parity and 17-hydroxy-progesterone levels, while diastolic blood pressure was positively associated with age and free testosterone index, but negatively associated with parity and 17-hydroxy-progesterone levels. Testosterone may increase blood pressure in pregnant women, while 17-hydroxy-progesterone may have the opposite effect.

Short-term Impact of Ambient Air Pollution and Air Temperature on Blood Pressure Among Pregnant Women

Epidemiologic studies have reported inconsistent findings for the association between air pollution levels and blood pressure (BP), which has been studied mainly in elderly subjects. Short-term air pollution effects on BP have not been investigated in pregnant women, who may constitute a vulnerable population. Between 2002 and 2006, 1500 pregnant women from a mother-child cohort study conducted in Nancy and Poitiers, France, underwent 11,220 repeated BP measurements (average, 7.5 measurements/woman). Nitrogen dioxide (NO₂), particulate matter with an aerodynamic diameter below 10 μm (PM₁₀), and meteorologic variables were measured on an hourly basis at permanent monitoring sites. We studied changes of BP in relation to short-term variations of air pollution and temperature with mixed models adjusted for meteorologic and personal characteristics. A 10°C decrease in temperature led to an increase in systolic BP of 0.5% (95% confidence interval = 0.1% to 1.0%). Elevated NO₂-levels 1 day, 5 days and averaged over 7 days before the BP measurement were associated with reduced systolic BP. The strongest decrease was observed for the 7-day NO₂ average (-0.4% [-0.7% to -0.2%] change for an 11 μg/m³ increase in NO₂). PM₁₀ effects on systolic BP differed according to pregnancy trimester: PM₁₀ concentration was associated with systolic BP increases during the first trimester and systolic BP decreases later in pregnancy. We observed short-term associations of air pollution and of temperature with BP in pregnant women. Whether such changes in BP have clinical implications remains to be investigated.

Tight control of mild-moderate pre-existing or non-proteinuric gestational hypertension

The question of the target blood pressure in pregnant women with mild-moderate hypertension continues to be an area of debate. To compare tight versus very tight control of mild-moderate pre-existing or non-proteinuric gestational hypertension for improving outcomes We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2011), CENTRAL (The Cochrane Library 2011, Issue 3), MEDLINE (January 1966 to March 2011), and the metaRegister of Controlled Trials (31 March 2011). We handsearched citation lists of relevant publications, review articles, and included studies. Randomized controlled trials of tight versus very tight control in pregnant women with mild or moderate pre-existing or non-proteinuric gestational hypertension. Two authors independently assessed trial quality and extracted data. We expressed results as risk ratio (RR) or mean differences, together with their 95% confidence intervals (CI). We included two studies (256 participants) with mild-moderate pre-existing or non-proteinuric gestational hypertension. There was no evidence of a difference between tight and very tight control groups regarding severe pre-eclampsia (risk ratio (RR) 1.28, 95% CI 0.97 to 1.70; two trials, 256 participants). More women in the tight group were hospitalized during their pregnancy (RR 2.53, 95% CI 1.14 to 5.63; one trial, 125 participants). There was no evidence of a difference in other outcome measures including fetal distress, IUGR, neonatal admission to a NICU, perinatal deaths, induction of labor and cesarean delivery between the tight and the very tight control groups. Gestational age at delivery had a non-significant mean difference (MD) of -0.15 weeks between the tight and very tight control groups (MD -0.15, 95% CI -1.52 to 1.21, random-effects, T² = 0.75, I² = 77%; two trials, 256 participants). The MD in birthweight between the tight and the very tight control group was not significant (MD -100.00 grams, 95% CI -363.69 to 163.69; one trial, 125 participants). For pregnant women with non-severe pre-existing or non-proteinuric gestational hypertension, there is insufficient evidence to determine how tight control of hypertension should be achieved to improve maternal and fetal-neonatal outcomes.

Effects of Guided Imagery on Blood Pressure in Pregnant Women with Hypertension: A Pilot Randomized Controlled Trial

Hypertension occurs in nearly 10 percent of pregnancies, and is associated with higher risk of infant and maternal morbidity and mortality than in normal pregnancies. Previous studies have suggested that relaxation therapies reduce blood pressure in nonpregnant adults. The objectives of this pilot randomized trial were to provide preliminary evidence of whether relaxation by means of guided imagery would reduce blood pressure in hypertensive pregnant women, and to assess the feasibility of a larger trial. A total of 69 pregnant women with hypertension were randomized to periods of guided imagery or of quiet rest, twice daily for 4 weeks or until delivery, whichever came first. Daytime ambulatory mean arterial pressure, systolic and diastolic blood pressure, and anxiety were measured weekly for up to 4 weeks. Women allocated to guided imagery had lower mean arterial pressure elevations over time than those allocated to quiet rest (guided imagery: M = 1.58 mmHg, SD = 7.63; quiet rest: M = 5.93 mmHg, SD = 6.55; t = 2.36, p = 0.02). However, when adjusted for baseline mean arterial pressure and gestation, the effect was not significant (p = 0.14). Numbers of women prescribed antihypertensive medication postrandomization were similar (guided imagery: n = 16; quiet rest: n = 13, χ(2) = 0.74, p = 0.46). There was also no evidence of an effect on women's anxiety. Nearly 90 percent (n = 26) of the guided imagery group indicated that they would use it again. Further rigorous study is warranted to determine effects of guided imagery on maternal blood pressure and perinatal health outcomes.