Liu Jieyu1, Cao Yingying2, Gong Tian3, Wang Jiaxiang1, Lu Jiawen1, Gu Yingjie4, Yu Qingzhou1, Teng Haoyue1, Yin Jieyun5, Pan Chenwei1. 1. Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China. 2. Maternal and Child Healthcare Center of Taicang, Jiangsu Province, China. 3. Maternal and Child Healthcare Center, Suzhou Municipal Hospital, Suzhou, Jiangsu Province, China. 4. Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China; Department of Obstetrics and Gynecology, International Peace Maternity & Child Health Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 5. Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China. Electronic address: jyyin@suda.edu.cn.
Abstract
OBJECTIVE: Visit-to-visit blood pressure variability (VVV) was an independent risk factor for cardiovascular events. In pregnant women whose hemodynamic changes are unique, the role of VVV in hypertensive disorders is still obscure. Therefore, we aimed to investigate the association of VVV with gestational hypertension (GH) and pre-eclampsia (PE). METHODS: 14,702 pregnant women were recruited at around 13 weeks of their gestation. VVV during the second, third trimester and the whole pregnancy, were estimated as standard deviation (SD) or coefficient of variation (CV) of systolic blood pressure (SBP) or diastolic blood pressure (DBP). The associations between VVV, GH and PE were assessed by multivariate logistic regression models. RESULTS: 878 and 131 women developed GH and PE, respectively. VVV was significantly higher in GH and PE subjects than normotensive controls, regardless of whichever metric was calculated. In maximally adjusted models, odds ratio (95% confidence interval) of SBP-CV during the whole pregnancy was 1.62 (1.56-1.68) for GH, 1.14 (1.06-1.21) for PE, and 1.51 (1.47-1.56) for either GH or PE. The cooperation of SBP-CV to other risk factors could help in discriminating pregnant women at high risk of GH and PE. CONCLUSIONS: VVV during pregnancy, especially SBP-CV, was independently associated with GH and PE. These results suggested that VVV could provide additional information to identify pregnant women at high risk of GH or PE. Further studies exploring prospective association between VVV, GH and PE are warranted.
OBJECTIVE: Visit-to-visit blood pressure variability (VVV) was an independent risk factor for cardiovascular events. In pregnant women whose hemodynamic changes are unique, the role of VVV in hypertensive disorders is still obscure. Therefore, we aimed to investigate the association of VVV with gestational hypertension (GH) and pre-eclampsia (PE). METHODS: 14,702 pregnant women were recruited at around 13 weeks of their gestation. VVV during the second, third trimester and the whole pregnancy, were estimated as standard deviation (SD) or coefficient of variation (CV) of systolic blood pressure (SBP) or diastolic blood pressure (DBP). The associations between VVV, GH and PE were assessed by multivariate logistic regression models. RESULTS: 878 and 131 women developed GH and PE, respectively. VVV was significantly higher in GH and PE subjects than normotensive controls, regardless of whichever metric was calculated. In maximally adjusted models, odds ratio (95% confidence interval) of SBP-CV during the whole pregnancy was 1.62 (1.56-1.68) for GH, 1.14 (1.06-1.21) for PE, and 1.51 (1.47-1.56) for either GH or PE. The cooperation of SBP-CV to other risk factors could help in discriminating pregnant women at high risk of GH and PE. CONCLUSIONS: VVV during pregnancy, especially SBP-CV, was independently associated with GH and PE. These results suggested that VVV could provide additional information to identify pregnant women at high risk of GH or PE. Further studies exploring prospective association between VVV, GH and PE are warranted.
Authors: Laura A Magee; Jeffrey Bone; Salwa Banoo Owasil; Joel Singer; Terry Lee; Mrutunjaya B Bellad; Shivaprasad S Goudar; Alexander G Logan; Salésio E Macuacua; Ashalata A Mallapur; Hannah L Nathan; Rahat N Qureshi; Esperança Sevene; Andrew H Shennan; Anifa Valá; Marianne Vidler; Zulfiqar A Bhutta; Peter von Dadelszen Journal: Hypertension Date: 2021-03-29 Impact factor: 10.190
Authors: Virginia R Nuckols; Seth W Holwerda; Rachel E Luehrs; Lyndsey E DuBose; Amy K Stroud; Debra Brandt; Alexandria M Betz; Jess G Fiedorowicz; Sabrina M Scroggins; Donna A Santillan; Justin L Grobe; Curt D Sigmund; Mark K Santillan; Gary L Pierce Journal: Hypertension Date: 2020-09-21 Impact factor: 9.897