This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ayala, D. E. Articles by Iglesias, M. Search for Related Content PubMed PubMed Citation Articles by Ayala, D. E. Articles by Iglesias, M.

(Hypertension. 1997;30:611.)
© 1997 American Heart Association, Inc.

Articles

Blood Pressure Variability During Gestation in Healthy and Complicated Pregnancies

Diana E. Ayala; Ramón C. Hermida; Artemio Mojón; José R. Fernández; Inés Silva; Rafael Ucieda; Manuel Iglesias

From the Bioengineering and Chronobiology Laboratories, ETSI Telecomunicación, University of Vigo, Campus Universitario, Vigo (D.E.A., R.C.H., A.M., J.R.F.); and the Obstetrics and Gynecology Department, Hospital General Clínico Universitario de Galicia, Medical School, University of Santiago, Santiago de Compostela (I.S., R.U., M.I.), Spain.

Abstract The evaluation of predictable variability in blood pressure by the use of ambulatory devices, and the proper processing of the time series thus obtained, can be useful for the early assessment of hypertensive complications in pregnancy. We have used this approach to quantify a predictable pattern of blood pressure and heart rate throughout pregnancy in clinically healthy women as well as in pregnant women who developed gestational hypertension or preeclampsia. We analyzed 503 blood pressure series from 71 healthy pregnant women and 256 series from 42 women who developed gestational hypertension or preeclampsia. Blood pressure monitoring (48-hour) was done once every 4 weeks after the first obstetric consultation. The pattern of variation along gestation of the 24-hour mean of blood pressure for groups of normotensive and hypertensive pregnant women was established by polynomial regression analysis. This method revealed predictable patterns of variation of 24-hour means with gestational age: for normotensive pregnant women, results indicate a steady decrease in blood pressure up to the 21st week of pregnancy, followed by an increase in blood pressure up to the day of delivery. This pattern of variation is not found in pregnancies complicated with gestational hypertension or even preeclampsia: the 24-hour mean of blood pressure is stable until the 22nd week of pregnancy and then correlated with gestational age, indicating a significant linear increase of blood pressure in the second half of pregnancy. For both healthy and complicated pregnancies, heart rate slightly increases until the end of the second trimester, and it is stable thereafter. This study confirms and extends to ambulatory everyday life conditions the predictable pregnancy-associated variability in blood pressure. The differences between uncomplicated and complicated pregnancies offer new end points for an early identification of gestational hypertension and preeclampsia.

Key Words: blood pressure • heart rate • pregnancy • hypertension, gestational • preeclampsia

This article has been cited by other articles:

				R. T. Mikolajczyk, J. Zhang, J. Ford, and J. Grewal Effects of Interpregnancy Interval on Blood Pressure in Consecutive Pregnancies Am. J. Epidemiol., August 15, 2008; 168(4): 422 - 426. [Abstract] [Full Text] [PDF]

				R. C. Hermida and D. E. Ayala Evaluation of the Blood Pressure Load in the Diagnosis of Hypertension in Pregnancy Hypertension, September 1, 2001; 38(3): 723 - 729. [Abstract] [Full Text] [PDF]

				R. C. Hermida, D. E. Ayala, and M. Iglesias Predictable Blood Pressure Variability in Healthy and Complicated Pregnancies Hypertension, September 1, 2001; 38(3): 736 - 741. [Abstract] [Full Text] [PDF]

				R. C. Hermida, D. E. Ayala, A. Mojon, and J. R. Fernandez Time-Qualified Reference Values for Ambulatory Blood Pressure Monitoring in Pregnancy Hypertension, September 1, 2001; 38(3): 746 - 752. [Abstract] [Full Text] [PDF]

				D. E. Ayala and R. C. Hermida Influence of Parity and Age on Ambulatory Monitored Blood Pressure During Pregnancy Hypertension, September 1, 2001; 38(3): 753 - 758. [Abstract] [Full Text] [PDF]

				R. C. Hermida, D. E. Ayala, A. Mojon, J. R. Fernandez, I. Alonso, I. Silva, R. Ucieda, and M. Iglesias Blood Pressure Patterns in Normal Pregnancy, Gestational Hypertension, and Preeclampsia Hypertension, August 1, 2000; 36(2): 149 - 158. [Abstract] [Full Text] [PDF]

				R. C. Hermida, D. E. Ayala, J. R. Fernandez, A. Mojon, I. Alonso, I. Silva, R. Ucieda, J. Codesido, and M. Iglesias Administration Time-Dependent Effects of Aspirin in Women at Differing Risk for Preeclampsia Hypertension, October 1, 1999; 34(4): 1016 - 1023. [Abstract] [Full Text] [PDF]

				R. C. Hermida, D. E. Ayala, A. Mojon, J. R. Fernandez, I. Silva, R. Ucieda, and M. Iglesias Blood Pressure Excess for the Early Identification of Gestational Hypertension and Preeclampsia Hypertension, January 1, 1998; 31(1): 83 - 89. [Abstract] [Full Text] [PDF]