scholarly journals Non-Dipping Patten of Blood Pressure and Gestational Hypertension

2018 ◽  
Author(s):  
Aleksandra Ilic ◽  
Djordje Ilic ◽  
Jelena Papović ◽  
Snezana Stojsic ◽  
Aleksandra Milovancev ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension

Diagnosing Gestational Hypertension and Preeclampsia With the 24-Hour Mean of Blood Pressure

Hypertension ◽  
1997 ◽  
Vol 30 (6) ◽  
pp. 1531-1537 ◽  
Author(s):  
Ramón C. Hermida ◽  
Diana E. Ayala
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension

scholarly journals Progesterone increases blood pressure in spontaneous gestational hypertension in rats

2005 ◽  
Vol 18 (1) ◽  
pp. 36-43 ◽  
Author(s):  
L SHARKEY ◽  
S KIRCHAIN ◽  
S MCCUNE ◽  
G SIMPSON ◽  
E ARCHAMBAULT ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension

Renal and cardiac oxidative/nitrosative stress in salt-loaded pregnant rat

2007 ◽  
Vol 293 (4) ◽  
pp. R1657-R1665 ◽  
Author(s):  
Annie Beauséjour ◽  
Véronique Houde ◽  
Karine Bibeau ◽  
Rébecca Gaudet ◽  
Jean St-Louis ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Pressure ◽  
Nitrosative Stress ◽  
Gestational Hypertension ◽  
Sodium Intake ◽  
Pregnant Rats ◽  
High Sodium ◽  
High Sodium Intake ◽  
Arterial Blood ◽  
Cardiac Ventricle

Sodium supplementation given for 1 wk to nonpregnant rats induces changes that are adequate to maintain renal and circulatory homeostasis as well as arterial blood pressure. However, in pregnant rats, proteinuria, fetal growth restriction, and placental oxidative stress are observed. Moreover, the decrease in blood pressure and expansion of circulatory volume, normally associated with pregnancy, are prevented by high-sodium intake. We hypothesized that, in these pregnant rats, a loss of the balance between prooxidation and antioxidation, particularly in kidneys and heart, disturbs the normal course of pregnancy and leads to manifestations such as gestational hypertension. We thus investigated the presence of oxidative/nitrosative stress in heart and kidneys following high-sodium intake in pregnant rats. Markers of this stress [8-isoprostaglandin F2α (8-iso-PGF2α) and nitrotyrosine], producer of nitric oxide [nitric oxide synthases (NOSs)], and antioxidants [superoxide dismutase (SOD) and catalase] were measured. Then, molecules (Na+-K+-ATPase and aconitase) or process [apoptosis (Bax and Bcl-2), inflammation (monocyte chemoattractant protein-1, connective tissue growth factor, and TNF-α)] susceptible to free radicals was determined. In kidneys from pregnant rats on 1.8% NaCl-water, NOSs, apoptotic index, and nitrotyrosine expression were increased, whereas Na+-K+-ATPase mRNA and activity were decreased. In the left cardiac ventricle of these rats, heightened nitrotyrosine, 8-iso-PGF2α, and catalase activity together with reduced endothelial NOS protein expression and SOD and aconitase activities were observed. These findings suggest that oxidative/nitrosative stress in kidney and left cardiac ventricle destabilizes the normal course of pregnancy and could lead to gestational hypertension.

Offspring’s blood pressure and metabolic phenotype after exposure to gestational hypertension in utero

2013 ◽  
Vol 28 (1) ◽  
pp. 87-98 ◽  
Author(s):  
Satu Miettola ◽  
Anna-Liisa Hartikainen ◽  
Marja Vääräsmäki ◽  
Aini Bloigu ◽  
Aimo Ruokonen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension ◽  
In Utero ◽  
Metabolic Phenotype

Hypertension

2020 ◽  
pp. 268-283
Author(s):  
Laura A. Magee ◽  
Peter von Dadelszen
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Disease Risk ◽  
Gestational Hypertension ◽  
Target Organ Damage ◽  
Expectant Management ◽  
Developed Countries ◽  
Chronic Hypertension ◽  
Pregnancy Hypertension ◽  
Premature Cardiovascular Disease

Pregnancy hypertension is associated with an estimated annual toll of 46,000 maternal and 2 million fetal, neonatal, and infant deaths. Over 99% of these deaths occur in less developed countries. The most dangerous form of pregnancy hypertension is pre-eclampsia, which, by international consensus, is defined more broadly than solely by proteinuric gestational hypertension to include markers of systemic target organ damage. Severe pre-eclampsia is defined by adverse features that mandate delivery irrespective of gestational age. There are numerous risk factors for pre-eclampsia and low-dose aspirin and, in women with low intake, calcium replacement appear to reduce the risk of pre-eclampsia and its complications. Time-of-disease risk estimation for women and, to a lesser extent, their fetuses, is possible to guide personalized decision-making and counselling. Heavy proteinuria is not an indication for delivery. Severe pregnancy hypertension must be treated as a matter of urgency. For all women with pregnancy hypertension, blood pressure should be normalized. Magnesium sulphate is the treatment to prevent and treat the seizures of eclampsia. Beyond viability, expectant management of pregnancy hypertension should be offered until 36+6 weeks of pregnancy. Women with either pre-eclampsia or gestational hypertension at more than 37+0 weeks should be offered induction, while induction should be offered to women with chronic hypertension at 38–39 weeks. Blood pressure reaches its maximal postpartum levels on days 3–6 postpartum. All forms of pregnancy hypertension are risk factors for premature cardiovascular disease and mortality, especially if associated with either fetal growth restriction, preterm birth, and/or stillbirth.

scholarly journals P1698MULTI- NATIONAL SURVEY AMONG NEPHROLOGISTS AND TRANSPLANT SURGEONS ABOUT THE SUITABILITY AND ACCEPTANCE OF MARGINAL LIVE KIDNEY DONORS WITH MILD HYPERTENSION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ziad Arabi ◽  
El Waleed El Hassan ◽  
Abdulrahman Altheaby ◽  
Abdullah Hamad ◽  
Kaysi Saleh
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension ◽  
Blood Pressure Monitoring ◽  
White Coat Hypertension ◽  
Kidney Donation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Kidney Donors ◽  
Increased Risk ◽  
Alternative Donor

Abstract Background and Aims There is variability among transplant centers in the acceptance of living donor candidates with well-controlled hypertension. Increased gestational hypertension and preeclampsia are more common in donors than in the general population especially if the donor is hypertensive at baseline. The purpose of this survey is to form a consensus about the evaluation of marginal live kidney donors (women and men) with hypertension. Method This is a cross-sectional survey of nephrologists and transplant surgeons about Suitability and Acceptance of The Marginal live Kidney Donors. The survey was sent to nephrologists in different countries and it was also distributed through AST & ERA-EDTA. Results A total of 122 practitioners from 22 countries responded to the survey. Of those, (N=96, 80.2%) were nephrologists and (n=23 19.83%) were transplant surgeons. The majority (45%) of the respondents were from USA. Most of the respondents (N=85, 69.7%) would allow a multiparous female (MPW) with mild and controlled hypertension (on a single blood pressure medication) who is not planning to have more children to donate. The rest would either advise against donation unless there is no alternative donor (n=23, 18.85%), or decline it altogether (n=14, 11.5%). In contrast, more respondents would reject a primiparous donor woman (PPW) with the same clinical scenario who considers having children (n=51, 42.2%, P=0.00001 ), or accept it only if there is no alternative donor (n=46, 38.0%, P=0.0009). Furthermore, most would not allow donation of a 20 years old male ( M) with an apparent white coat hypertension if his 24-hour ambulatory blood pressure monitoring shows non-dipping nocturnal pattern (n=67, 54.9%), or only accept it if there is no alternative donor (n=36, 29.5%). When comparing the rejection rate among the three donors: 11% for MPW, 41% for PPW and 54% for M. (P = 0.0001 for MPW vs PPW; P=0.00001 for MPW vs M; P=0.04 for PPW vs M). Conclusion Most of the nephrologists and transplant surgeons will clear mulptiparous women with mild and controlled hypertension for kidney donation as long as there no further plans for pregnancy. However, the majority of respondents will not clear a hypertensive primiparous due to the increased risk of gestational hypertension and preeclampsia after kidney donation. Most would be also reluctant to accept very young male donors if they show indicators of higher risk of developing hypertension in future.

P2639The influence of non-dipping pattern of blood pressure in gestational hypertension on early onset of hypertension later in life

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Ilic ◽  
S Stojsic ◽  
J Papovic ◽  
D Grkovic ◽  
T Miljkovic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Regression Analysis ◽  
Left Ventricle ◽  
Pregnant Women ◽  
Preterm Delivery ◽  
Gestational Hypertension ◽  
Systolic Function ◽  
Blood Pressure Monitoring ◽  
Night Time ◽  
Lv Mass

Abstract Background It is known that gestational hypertension (GH) and preeclampsia have been associated with the onset of hypertension later in life. We wondered if the blood pressure (BP) pattern affects the incidence of hypertension in the future. Purpose The aim of this study was to determine whether hypertension occurs more frequently if a non-dipping pattern was registered during GH, but also if non-dipping pattern in GH afects deterioration of systolic function of the left ventricle (LV) later in life. Methods This longitudinal study included 56 pregnant women with gestational hypertension (of which 28 met criteria for non-dipping pattern of BP, according to the values registrated by the ambulatory blood pressure monitoring (ABPM) – non-dippers, while other 28 were classified in dippers) and 27 normotensive pregnant women, as control. All of women became normotensive after delivery, but they continued to be periodically controlled in term of values of blood pressure. The function and morphology of the left ventricle (LV) were analyzed by echocardiography exam in the third trimester of pregnancy and 5 years after delivery, as well as ABPM, while 2D longitudinal strain (LS) was performed only after delivery in order to evaluate systolic function of the LV. All echo and ABPM parameters recorded during pregnancy, also as parameters of pregnancy outcome – intrauterine growth restriction (IUGR) and preterm delivery, were analyzed, in order to relate them with later onset of hypertension. Results After, average 5 years, diagnosis of hypertension was determined in 8 women (2 from dipper group – during pregnancy – 7,1%, and 6 from non-dipper group 21,4%). Those 8 hypertensive women had significantly reduced LS: −18,12±1,3 compared to normotensive −19,9±1,4 (p=0,001). It is very interesting that, 5 years after delivery, values of 2D LS were, although in reference values, significantly reduced in women who were non-dippers (−19,32±1,38) during GH, compared with both, normotensive (−20,69±1,18; p<0,0005) and dippers (−20,10±1,29; p=0,026). Univariate regression analysis revealed that higher values of day and night BP, the mean arterial BP, LV mass index, preterm delivery and IUGR were associated with onset of hypertension later in life, while parameters of systolic and diastolic function of the LV during pregnancy, didn't affect occurrence of it. As revealed by multivariate regression analysis, the peak value of night-time diastolic blood pressure during pregnancy (p=0,016; OR=1,127; 95% CI: 1,022–1,242) and the LV mass index, also during pregnancy (p=0,041; OR=1,099; 95% CI: 1,004–1,203) had strong relation with hypertension in future life. Conclusion The non-dipping pattern of blood pressure in gestationl hypertension is significant associate with onset of hypertension later in life, but also with decreased systolic function of the left ventricle. Acknowledgement/Funding Provincial Secretariat for Health of the Autonomous Province of Vojvodina

scholarly journals Impact of the 2017 ACC/AHA Guideline for High Blood Pressure on Evaluating Gestational Hypertension–Associated Risks for Newborns and Mothers

2019 ◽  
Vol 125 (2) ◽  
pp. 184-194 ◽  
Author(s):  
Jie Hu ◽  
Yuanyuan Li ◽  
Bin Zhang ◽  
Tongzhang Zheng ◽  
Jun Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Preterm Delivery ◽  
High Blood Pressure ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Gestational Hypertension ◽  
Blood Pressure Elevation ◽  
Early Term ◽  
Term Delivery ◽  
The Impact

Rationale: In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) released a new hypertension guideline for nonpregnant adults, using lower blood pressure values to identify hypertension. However, the impact of this new guideline on the diagnosis of gestational hypertension and the associated maternal and neonatal risks are unknown. Objective: To estimate the impact of adopting the 2017 ACC/AHA guideline on detecting gestational blood pressure elevations and the relationship with maternal and neonatal risk in the perinatal period using a retrospective cohort design. Methods and Results: This study included 16 345 women from China. Systolic and diastolic blood pressures of each woman were measured at up to 22 prenatal care visits across different stages of pregnancy. Logistic and linear regressions were used to estimate associations of blood pressure categories with the risk of preterm delivery, early-term delivery, and small for gestational age, and indicators of maternal liver, renal, and coagulation functions during pregnancy. We identified 4100 (25.1%) women with gestational hypertension using the 2017 ACC/AHA guideline, compared with 4.2% using the former definition. Gestational hypertension, but not elevated blood pressure (subclinical blood pressure elevation), was significantly associated with altered indicators of liver, renal, and coagulation functions during pregnancy for mothers and increased risk of adverse birth outcomes for newborns; adjusted odds ratios (95% CIs) for gestational hypertension stage 2 were 2.23 (1.18–4.24) for preterm delivery, 2.05 (1.67–2.53) for early-term delivery, and 1.43 (1.13–1.81) for small for gestational age. Conclusions: Adopting the 2017 ACC/AHA guideline would result in a substantial increase in the prevalence of gestational hypertension; subclinical blood pressure elevations during late pregnancy were not associated with increased maternal and neonatal risk in this cohort. Therefore, the 2017 ACC/AHA guideline may improve the detection of high blood pressure during pregnancy and the efforts to reduce maternal and neonatal risk. Replications in other populations are required.

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