Breaking News
April 22, 2018 - AYOXXA to develop multiplex immunoassay to support treatment of sepsis patients
April 22, 2018 - New Drug Combo Ups Survival in HER2/neu Uterine Serous Cancer
April 22, 2018 - Researchers chart a new way to look at concussion
April 22, 2018 - Every parent needs to know fundamental red flags for autism
April 22, 2018 - Anatotemp expands anatomic dental implant healing abutments with 4Side anti-rotational connection
April 22, 2018 - Gene Twist Can Make Your Blood Pressure Spike From Salt
April 22, 2018 - Study suggests failed osteoarthritis drug could help treat opioid addiction
April 22, 2018 - More Americans aware of growing problem of opioid addiction
April 22, 2018 - KHN’s ‘What the Health?’ Nothing in health care ever goes away
April 22, 2018 - BGS to promote high-quality sterilization services at Health GB in Manchester
April 22, 2018 - New integrated POC tool detects biomarkers of heart failure rapidly and precisely
April 22, 2018 - Direct electrical current can be delivered to nerves for blocking pain signals
April 22, 2018 - Newly Published Phase 2 Study Found Esketamine Demonstrated Significantly Rapid Improvements in Depressive Symptoms and Suicidality
April 22, 2018 - Healthy red blood cells owe their shape to muscle-like structures
April 22, 2018 - Researchers present case study of management of rheumatic mitral regurgitation in woman contemplating pregnancy
April 22, 2018 - New black Porvair Krystal UV Quartz microplates for Circular Dichroism measurements
April 22, 2018 - Advanced flow chemistry modules enhance control of nanoprecipitation
April 22, 2018 - Look! Down in the petri dish! It’s a superplatelet!
April 22, 2018 - Research reveals why people with tetraplegia more likely to suffer from sleep apnea
April 21, 2018 - New non-invasive nerve stimulation may offer relief for people with hand tremor
April 21, 2018 - Smartphone App May Up Medication Adherence in HTN
April 21, 2018 - Western diet depletes artery-protecting immune cells
April 21, 2018 - Excelitas Technologies launches new powerful LED light source for fluorescence microscopy
April 21, 2018 - Academia and high tech companies join forces to increase production capacity for microfluidic systems
April 21, 2018 - Developing cooking skills as young adult may have long-term health benefits
April 21, 2018 - Study compares survival outcomes of different drugs for type 2 diabetes
April 21, 2018 - More Than 40 Percent of Americans Breathe Dirty Air: Report
April 21, 2018 - Obstructive sleep apnea – Genetics Home Reference
April 21, 2018 - More evidence shows exposure to traffic and outdoor air pollution increases risk of asthma
April 21, 2018 - Novel gold nanoparticle technology could guide cancer treatment in real-time
April 21, 2018 - News coverage of Ebola impacted public’s perception on disease and survivors
April 21, 2018 - S.Africa’s DIY battle against HIV
April 21, 2018 - Children with autism have gastrointestinal and immune system deregulation, research finds
April 21, 2018 - Human brain processes sight and sound in the same way, shows study
April 21, 2018 - Evolutionary history of tumor helps predict severity of prostate cancer
April 21, 2018 - Pepper plant metabolizes antibiotic in personal care products
April 21, 2018 - Tradeshow Talks with Integra
April 21, 2018 - EPFL becomes part of Chan Zuckerberg’s project to develop Human Cell Atlas
April 21, 2018 - Pfizer Announces Positive Topline Results From Phase 3 ATTR-ACT Study Of Tafamidis In Patients With Transthyretin Cardiomyopathy
April 21, 2018 - Breaking through the HIV vaccine ‘logjam’
April 21, 2018 - IntelliCyt introduces new QSol buffer to enable robust, consistent sampling
April 21, 2018 - Scientists publish comprehensive lineage tree of whole adult animal in Science journal
April 21, 2018 - Innovative method based on FluidFM technology could revolutionize biological research
April 21, 2018 - Americans world’s biggest TV addicts, watching four hours a day
April 21, 2018 - Investigational drug may help increase protein levels in babies with spinal muscular atrophy
April 21, 2018 - Study shows distinctions between age groups in predicting and responding to stress at home
April 21, 2018 - Aziyo Biologics, BIOTRONIK enter into US co-distribution agreement
April 21, 2018 - Opiate Use Linked to Early Mortality in IBD Patients
April 21, 2018 - Online ads help pregnant smokers quit
April 21, 2018 - Opioid pain medications may not be safe for hemodialysis patients
April 21, 2018 - Rare variants in non-coding DNA inherited from parents heighten autism risk
April 21, 2018 - A needleless glucose monitor for diabetes patients
April 21, 2018 - BD introduces new informatics and automation solutions for clinical laboratories
April 21, 2018 - Turn Chores Into a Fitness Routine
April 21, 2018 - DNA methylation plays key role in stem cell differentiation
April 21, 2018 - Scientists find link between soil metals and cancer mortality
April 21, 2018 - Experts discuss implications of low calcium intake in global population
April 21, 2018 - GNA Biosolutions to display Pharos V8 Laser PCR instrument at Analytica trade fair
April 21, 2018 - People with vitamin D deficiency may be at greater risk of diabetes
April 21, 2018 - Study findings could open new possibilities for treating cancer with adenovirus
April 21, 2018 - People who use medical marijuana have higher rates of prescription drug use, study finds
April 21, 2018 - Study debunks ‘myth’ that strenuous exercise dampens immunity
April 21, 2018 - FDA approves marijuana based medication for epilepsy treatment
April 21, 2018 - Researchers find novel genes for longevity in mammals
April 21, 2018 - GNA Biosolutions and project partners launch new research project to develop TB diagnostic platform for POC applications
April 21, 2018 - $2 million funding boosts progress of UAB biomedical startup
April 21, 2018 - Scientists identify gene responsible for evolution of recombination rates
April 21, 2018 - UConn researchers develop new composite for healing broken load-bearing bones
April 21, 2018 - Study examines how higher-order gene combinations help maintain normal cell physiology
April 21, 2018 - Study challenges use of whole-brain radiation for small-cell lung cancer patients with brain metastases
April 21, 2018 - Researchers discover blood biomarkers that may help detect, confirm mild traumatic brain injury
April 21, 2018 - People who become physically active after heart attack more likely to live longer, shows research
April 21, 2018 - CPRIT awards $2 million grant to push forward breast cancer research in West Texas
April 21, 2018 - Unhealthy diet damages the development of immature fat cells, study shows
April 21, 2018 - Consumption of protein supplements with meals may provide better weight control
April 21, 2018 - 4 Types of Foods to Help Boost Your Memory
April 21, 2018 - How did gonorrhea become a drug-resistant superbug?
April 21, 2018 - DePuy Synthes announces clinical results related to use of CORAIL Hip System Femoral Stems
April 21, 2018 - New initiative launched to support goals of Human Cell Atlas
April 20, 2018 - Teen patient gets a new lease on life
Ambulatory Monitoring Shows Persistent HTN Common After Severe Preeclampsia

Ambulatory Monitoring Shows Persistent HTN Common After Severe Preeclampsia

image_pdfDownload PDFimage_print

Action Points

  • Many women with severe preeclampsia had hypertension on ambulatory blood pressure monitoring 1 year after delivery, and fewer than a quarter of these women would have been diagnosed with office blood pressure measurement alone.
  • Be aware that preeclampsia affects 3% to 5% of pregnancies in the developed world, and is characterized by hypertension and new onset of proteinuria or organ dysfunction after 20 weeks of gestation.

Fully 41.5% of women with severe preeclampsia had hypertension on ambulatory blood pressure monitoring 1 year after delivery, researchers found.

Masked hypertension — defined in the study by closer to what is now the threshold for stage 2 hypertension, 135/85 mm Hg at home — was the most common (17.5%), followed by sustained hypertension (14.5%) and white coat hypertension elevated only in the clinic (9.5%).

Fewer than a quarter of these women would have been diagnosed as hypertensive with office blood pressure measurement alone, Laura Benschop, MD, of Erasmus Medical Center in Rotterdam, The Netherlands, and colleagues reported in Hypertension.

“Optimal timing and type of screening in the postpartum period for women with preeclampsia is not yet totally clear, and is an area of very active research,” Kristen Cleary, MD, of NewYork Presbyterian/Columbia University Irving Medical Center in New York City and who was not involved in the research, said in a statement. “These women should be followed on a regular basis after delivery for high blood pressure, and primary care doctors should be aware of this important issue in their patients’ medical history.”

Benschop and colleagues noted that recent studies found women with preeclampsia often have hypertension after pregnancy, which contributes to cardiovascular disease and stroke risk. While prior studies measured only office blood pressure to determine preeclampsia and hypertension, they said that ambulatory blood pressure monitoring, using a small machine to be worn on a belt for 24 hours, is the “gold standard” to rule out either masked hypertension or white coat hypertension and assess for a dipping pattern, or the systolic night-to-day blood pressure ratio.

“Sustained hypertension, masked hypertension, [white coat hypertension] and a disadvantageous dipping pattern are all independent risk factors for future [cardiovascular disease] and therefore clinically important,” the authors wrote.

Researchers examined 200 women with a history of severe preeclampsia, who met several pre-specified criteria, including systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥110 mm Hg on two occasions at least 6 hours apart and proteinuria ≥5 g per 24 hours or ≥3+ on two urine samples collected at least 4 hours apart.

They were followed for 1 year after pregnancy and had 24-hour blood ambulatory blood pressure monitoring, as well as an office blood pressure measurement between 9 and 15 months after delivery.

Study participants were a mean of 31.6 years old, and 70% were nulliparous. Three-quarters of women were diagnosed with early-onset preeclampsia, with an average gestational age at diagnosis of 30.5 weeks. A little under 70% of infants born to the group were small for gestational age.

The authors also noted that 15.7% of women had moderately-increased albuminuria, a symptom of kidney disease, while 3.4% of women had severely-increased albuminuria a year after pregnancy.

About 20% of women were already receiving treatment for previously-diagnosed hypertension. About 55% of women with sustained hypertension had been diagnosed with hypertension prior to ambulatory blood pressure monitoring, as well as 31.4% of women with masked hypertension and 47.4% of women with white coat hypertension. Moreover, three-quarters of women who were diagnosed with hypertension prior to ambulatory blood pressure monitoring did not “receive optimal antihypertensive drug treatment” or were non-adherent to it.

In addition, 45.5% of women had a risk-associated pattern of systolic night-to-day blood pressure ratio dipping, and “this percentage was equal between women with a normotensive and hypertensive daytime ambulatory blood pressure monitoring,” the authors said.

Limitations to the data included the descriptive design of the study, which meant that differences in hypertension prevalence and dipping pattern between women with previous preeclampsia and those with a previous normotensive pregnancy or other gestational hypertension disorder could not be examined. The researchers also noted findings may not be generalizable to all women and noted the portion of women with albuminuria, which has the tendency to affect blood pressure.

The authors disclosed no conflicts of interest.

2018-02-07T12:30:00-0500

Tagged with:

About author

Related Articles