Document Detail

Can 24-hour ambulatory blood pressure measurement predict the development of hypertension in primigravidae?
MedLine Citation:
PMID:  9091016     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the role of 24-hour ambulatory blood pressure measurement in the mid-second trimester as a predictive test for the development of hypertension in pregnancy. DESIGN: Prospective intervention. SETTING: The Rotunda Hospital, Dublin. PARTICIPANTS: One thousand one hundred and two healthy primigravid women. INTERVENTION: 24-hour ambulatory blood pressure measurement at 18 to 24 weeks of gestation. MAIN OUTCOME MEASURES: The development of pre-eclampsia or gestational hypertension. RESULTS: A total of 1048 women had sufficient readings to be included in the final analysis. Of these, 23 (2.2%) developed pre-eclampsia, 64 (6.1%) developed gestational hypertension and 961 (91.7%) remained normotensive. Significantly higher ambulatory blood pressures were recorded in both the pre-eclamptic and gestational hypertensive group compared with the normotensive group. In addition, the gestational hypertensive group had significantly higher clinically measured blood pressure compared with the normotensive group. There were no differences between the pre-eclamptic and the gestational hypertensive group for any of the blood pressure parameters analysed. The best overall predictor for pre-eclampsia was 24-hour mean diastolic pressure which using a cutoff level of 71 mmHg gave a test with a sensitivity of only 22% and a positive predictive value of 15%. CONCLUSION: Because the absolute differences are small and the overlap between the hypertensive and normotensive groups large, ambulatory blood pressure measurement, in a healthy primigravid population, between 18 and 24 weeks of gestation is not a useful predictor of hypertension.
J R Higgins; J J Walshe; A Halligan; E O'Brien; R Conroy; M R Darling
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British journal of obstetrics and gynaecology     Volume:  104     ISSN:  0306-5456     ISO Abbreviation:  Br J Obstet Gynaecol     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-04-10     Completed Date:  1997-04-10     Revised Date:  2010-08-25    
Medline Journal Info:
Nlm Unique ID:  7503752     Medline TA:  Br J Obstet Gynaecol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  356-62     Citation Subset:  AIM; IM    
Rotunda Hospital, Dublin, Ireland.
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MeSH Terms
Blood Pressure
Blood Pressure Monitoring, Ambulatory*
Hypertension / diagnosis*
Pre-Eclampsia / diagnosis
Pregnancy Complications, Cardiovascular / diagnosis*
Pregnancy Trimester, Second
Prospective Studies
Grant Support
//Wellcome Trust
Erratum In:
Br J Obstet Gynaecol 1997 Aug;104(8):974

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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