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(Hypertension. 2009;53:e12.)
© 2009 American Heart Association, Inc.

Letters to the Editor

Detection of Midpregnancy Fall in Blood Pressure by Out-of-Office Monitoring

Departments of Clinical Pharmacology and Therapeutics and Medical Genetics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan, Japan Society for the Promotion of Science, Tokyo, Japan

Takayoshi Ohkubo

Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan, Tohoku University 21st Century Center of Excellence Program, Comprehensive Research and Education Center, for the Planning of Drug Development and Clinical Evaluation, Sendai, Japan

Yurie Sato

Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan

Maiko Kawaguchi

Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan

Misato Nishimura

Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan

Yumiko Watanabe

Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan, Tohoku University Institute for International Advanced Research and Education, Sendai, Japan

Yutaka Imai

Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan, Tohoku University 21st Century Center of Excellence Program, Comprehensive Research and Education Center for the Planning of Drug Development and Clinical Evaluation, Sendai, Japan

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

Silva et al¹ have demonstrated the absence of a midpregnancy fall in diastolic blood pressure (BP) in women with a low educational level. Their previous articles also showed that maternal socioeconomic status is associated with a risk of gestational hypertension and preeclampsia.² However, they did not demonstrate a midpregnancy fall in systolic BP in all of the educational subgroups. This might be attributable to few measurement points being obtained during pregnancy or to some other confounding factors.

Ambulatory BP measurement is one way to resolve inferior results from isolated BP measurements. Hermida et al³ measured ambulatory BP in 403 pregnant women for 48 consecutive hours every 4 weeks from the first obstetric visit until delivery. They found that BP steadily decreased up to 20 weeks of pregnancy and increased up to the day of delivery. Conversely, in women with gestational hypertension and preeclampsia, BP remained stable until the 22nd week of gestation and then linearly increased for the remainder of the pregnancy.

The American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association scientific statements indicate that home BP monitoring might overcome many of the limitations of traditional office BP measurements, and it is less expensive and easier to perform than ambulatory BP monitoring.⁴ Home BP measurements are theoretically ideal for monitoring changes in BP during pregnancy, because home measurement is the optimal way to record multiple readings taken at the same time of day over prolonged periods.⁴ We recently conducted a prospective observational study . . . [Full Text of this Article]

This article has been cited by other articles:

				L. M. Silva, E. A.P. Steegers, A. Burdorf, V. W.V. Jaddoe, L. R. Arends, A. Hofman, J. P. Mackenbach, and H. Raat Response to Detection of Midpregnancy Fall in Blood Pressure by Out-of-Office Monitoring Hypertension, February 1, 2009; 53(2): e14 - e14. [Full Text] [PDF]