| Circadian rhythm of blood pressure challenges office values as the "gold standard" in the diagnosis of gestational hypertension. | |
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MedLine Citation:
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PMID: 12638696 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Despite poor sensitivity and specificity, office blood pressure (BP) determinations are still the "gold standard" for diagnosing gestational hypertension. This prospective blind study evaluates the prognostic value of office values as compared with ambulatory monitoring in pregnancy. We analyzed 2175 BP series systematically sampled from 355 non-preeclamptic pregnant women for 48 h every 4 wks from the first hospital visit until delivery. Women were divided for comparative purposes into three groups: "detected" gestational hypertension, defined on the basis of casual clinical BP> 140/90 mmHg after 20 wks of gestation and hyperbaric index (area of BP excess above the upper limit of a time-specified tolerance interval adjusted for the circadian pattern of the reference population) consistently above the threshold for diagnosing hypertension in pregnancy; "undetected" gestational hypertension, women with office BP < 140/90 mmHg but hyperbaric index consistently above the threshold for diagnosis; and normotension, women with both office values and hyperbaric index below the respective thresholds for diagnosis. Small and insignificant differences in the 24h mean BP between "detected" and "undetected" gestational hypertension is observed in all trimesters, in contrast with highly significant differences between these two groups and normotensive pregnancies. Normotensive women are characterized by highly significant lesser incidence by 60% in preterm delivery, 70% in intrauterine growth retardation, and 50% in delivery by cesarean section (p < 0.001) compared with women with "detected" and "undetected" gestational hypertension (p > 0.715). In pregnancy, the hyperbaric index is markedly superior to office BP measurements for diagnosis of what should be truly considered gestational hypertension, and for prediction of the outcome of pregnancy. |
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Authors:
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Ramón C Hermida; Diana E Ayala; Manuel Iglesias |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Chronobiology international Volume: 20 ISSN: 0742-0528 ISO Abbreviation: Chronobiol. Int. Publication Date: 2003 Jan |
Date Detail:
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Created Date: 2003-03-17 Completed Date: 2004-02-09 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8501362 Medline TA: Chronobiol Int Country: United States |
Other Details:
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Languages: eng Pagination: 135-56 Citation Subset: IM |
Affiliation:
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Bioengineering and Chronobiology Laboratories, University of Vigo, Campus Universitario, Vigo, Spain rhermida@tsc.uvigo.es |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Pressure / physiology* Blood Pressure Monitoring, Ambulatory Circadian Rhythm / physiology* Female Humans Hypertension / diagnosis*, physiopathology Pre-Eclampsia / diagnosis*, physiopathology Pregnancy Pregnancy Complications, Cardiovascular / diagnosis*, physiopathology Pregnancy Trimesters Reference Standards Sensitivity and Specificity |
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