[PP.24.09] ABPM AS A PREDICTOR OF EVENT IN PREGNANCY: VALUE OF THE PATTERN OF NIGHT DROP OF BLOOD PRESSURE AND THE VALUES OF THE DIASTOLIC ARTERIAL PRESSURE. (September 2016)

• Record Type: Journal Article
• Authors: Correia, A.; Vidal, S.; Cadete, A.; Ferreira, R.; Rainho, C.; Leitão, F.; Gonzaga, A.; Bastos, J.
• Is Part Of: Journal of hypertension. Volume 34:(2016) Supplement 2
• Publication Date: 2016-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000492102.42261.03
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: It is still not well known the prognostic cardiovascular (CV) value of 24 h ambulatory blood pressure monitoring (ABPM) in the pregnant woman with hipertension (HT). The authors intended to assess the prognostic value of ABPM, in pregnant women with HT in predicting maternofetal event during pregnancy. Design and method: Prospective and observational study which included 139 pregnant women designed from the Obstetrics appointment to the HT appointment, having done the ABPM, between January 2007 and June 2015. The follow-up occured until the child-birth (262 ± 28 days). The definied events were: mother, fetal or neonatal dead, pre-eclampsia, eclampsia, gestational diabetes, prematurity and fetal growth restriction. Results: The study included 139 pregnant women with the age of 32 ± 6 years, 58% with cronic HT, 42% with gestacional HT. In the follow-up, were detected 71 events. About the parameters of the ABPM, the Systolic Blood Pressure dipping (SBP) verified: 87 with Dipper (D) pattern and 51 with non-Dipper (ND) pattern. Comparing pattern D vs ND, the D pattern had statisticaly significant reduction of the events (X2, p < 0, 017). In the analysis of curves survivor of Kaplan-Meier free of events, the ND patter was associated with worst curves of survivor free of events (log rank 6.22, p < 0, 01). In a multivariate Cox analysis adjusted for potential confounders (age, obstetric, personal and family history, body mass index) 24 h diastolic blood pressure (DBP), 24 h SBP and night DBP were predictive of maternofetal events, respectivelly (Hazzard ratio 1.03, (95% CI 1.00–1.05; p < 0.02); HR 1.03, (95% CI 1.01–1.06; p < 0, 02); HR 1.04, (95% CI 1.01 -1.07; p < 0, 01)), specially the night DBP. Conclusions: In our sample the ABPM found that SBP dipping and night DBP were predictive of events in puerperal, pregnancy and newborn, mainly the night DBP dippping. The authors consider that ABPM is a tool for pregnant with HT, because this is one method available that analyzes the night blood pressure which seems to be the most important.