A new definition of gestational hypertension? New-onset blood pressures of 130 to 139/80 to 89 mm Hg after 20 weeks of gestation

Porcelli, Bree A.; Diveley, Emily; Meyenburg, Kaytelyn; Woolfolk, Candice; Rosenbloom, Joshua I.; Raghuraman, Nandini; Stout, Molly J.; Sabol, Bethany

doi:10.1016/j.ajog.2020.06.019

Cited by 22 publications

(11 citation statements)

References 16 publications

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“…Although high‐normal BP in pregnancy is currently classified as normal, such women are at significantly increased risk of developing HDP as shown in the above studies. Further investigation should be performed to determine the optimal threshold of abnormal BP during pregnancy 15 …”

Section: Discussionmentioning

confidence: 99%

“…Further investigation should be performed to determine the optimal threshold of abnormal BP during pregnancy. 15 As a routine monitoring index in prenatal care and a key indicator for the diagnosis of HDP, BP reflects subclinical vascular status among young adults. 16 Regular BP measurement can help early warning of HDP, which is often asymptomatic in the first and second trimesters.…”

Section: Discussionmentioning

confidence: 99%

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The relationship between high–normal blood pressure in the first half of pregnancy and the risk of hypertensive disease of pregnancy

Zou

Yang

Cai³

et al. 2022

J of Clinical Hypertension

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Early warning of hypertensive disorder in pregnancy (HDP) can improve maternal and infant outcomes. However, few studies had evaluated the warning value of highnormal blood pressure (BP) before the onset of HDP. This was a prospective cohort study to investigate the relationship between high-normal BP in the first half of pregnancy and the risk of HDP. According to the maximum BP measured before 20 +6 weeks of gestation, the cohort was divided into three groups: optimal BP (SBP < 120 mmHg and DBP < 80 mmHg), normal BP (120 mmHg ≤ SBP < 130 mmHg or 80 mmHg ≤ DBP < 85 mmHg), and high-normal BP (130 mmHg ≤ SBP < 140 mmHg or 85 mmHg ≤ DBP < 90 mmHg). The relationship between different BP levels in the first half of pregnancy and HDP risk was assessed by general linear models. Ten thousand one hundred and ninety-three normotensive pregnant women with complete information were finally included for data analysis. Among them, 532 pregnant women were diagnosed with HDP, with a total HDP incidence of 5.2%. The incidences in the optimal, normal, and high-normal BP groups were 2.4%, 6.0%, and 21.8%, respectively. Compared to women with optimal BP in the first half of pregnancy, women with high-normal BP had a 445% increased risk of HDP (aRR: 5.45, 95% CI: 4.24-7.00), and even women with normal BP had a 107% increased risk of HDP (aRR: 2.07, 95% CI: 1.68-2.56). This study demonstrated that among low-risk healthy women, women with high-normal BP in the first half of pregnancy had a significantly higher risk of HDP.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The relationship between high–normal blood pressure in the first half of pregnancy and the risk of hypertensive disease of pregnancy

Zou

Yang

Cai³

et al. 2022

J of Clinical Hypertension

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“…Estos valores de referencia son el estándar desde hace muchos años 5 . Siguiendo los cambios recientes por el Colegio Americano de Cardiología (American College of Cardiology, ACC) con umbrales menores para la definición de hipertensión en población no gestante 6 , se mejoró la detección de resultados adversos maternos y perinatales aplicando estos nuevos valores [7][8][9][10][11][12][13][14] , a pesar de que la gestación no da tiempo suficiente para evaluar morbilidad cardiovascular a largo plazo. Estos umbrales se establecieron con base en la opinión de expertos, válida pero con el menor nivel de evidencia según la clasificación GRADE 15 .…”

Section: Introductionunclassified

Definición de la presión arterial normal a las 11-14 semanas de gestación según riesgo

Valenzuela-Muhech¹,

Cervantes-Ricaud²,

Carrasco-Blancas³

et al. 2023

ACM

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Objetivo: Definir la presión arterial normal en el primer trimestre de la gestación según el desempeño para predecir preeclampsia. Método: Estudio de cohorte en embarazos de feto único, según el modelo de riesgos en competencia para preeclampsia. La presión arterial se midió de manera estandarizada entre las 11 y 14 semanas de gestación. Resultados: En 797 embarazos incluidos hubo 40 (5.0%, intervalo de confianza del 95% [IC 95%]: 3.6-6.4) partos con preeclampsia. Las presiones arteriales sistólica, diastólica y media fueron respectivamente de 101 ( 9), 68 (8) y 79 ( 8) mmHg en las embarazadas que no desarrollaron preeclampsia, frente a 109 (10), 75 (8) y 86 ( 8) mmHg en las que sí (p < 0.001, prueba t de Student). Las áreas bajo la curva fueron 0.707 (0.637-0.777), 0.728 (0.661-0.795) y 0.738 (0.673-0.803). A 3% de falsos positivos, los puntos de corte fueron 119, 83 y 94 mmHg con valores predictivos negativos del 95.6%. Conclusiones: Es factible definir normalidad para la presión arterial en el embarazo con base bioestadística y clínica.

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“…With an increase in cardiac output, blood pressure values in pregnancy are increased, systemic vasodilation leads to a decrease in total peripheral resistance of blood vessels and blood pressure remains within the normal range. [1][2][3][4][5] Pregnancy-induced hypertension (PIH) is one of the main causes of morbidity (up to 10 %) and mortality in pregnant women (up to 14 %). [6][7][8] In hypertension, there is a disturbance of the balance of vasomotor influences that leads to vasoconstriction and possible closure of vessels in the microcirculation.…”

Section: Introductionmentioning

confidence: 99%

The research of correlation between blood pressure and nailfold capillary parameters in exercising and non-exercising pregnant women

Ljubojević¹,

Bojanić²,

Nožica-Radulović³

et al. 2022

Scripta Medica

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Background/Aim: With an increase in cardiac output, blood pressure values in pregnancy increase. The aim of the study was to examine the effect of prenatal exercises on the circulatory parameters and the correlation between blood pressure and nailfold capillary parameters in healthy pregnant women. Methods: The blood pressure shape and length of nailfold capillary were assessed in 35 non-exercising pregnant women and 35 pregnant women who exercised, at the beginning of the study (between 20 and 32 gestational week) and the end of the study (28 - 40 gestational week). Results: The elevation in blood pressure was significantly lower in pregnant women who exercised in relation to non-exercising pregnant women. After eight weeks, the length of the capillary loops was increased by 30 µm and the number of pregnant women with pronounced shape changes of capillary loops increased, with no difference between the groups. Non-exercisers had a correlation between the change in diastolic pressure and the increase in capillary length (r = 0.53, p = 0.001). In the experimental group, the correlation between the change in blood pressure and the increase in the length of capillary loops was not determined. Conclusion: Prenatal physical activity had a beneficial impact on the circulation of pregnant women. In pregnant women in the third trimester, after eight weeks of follow-up, the length of the nailfold capillary loops and the presence of pronounced shape changes of capillary loops were increased, without difference between exercisers and non-exercisers. In non-exercising pregnant women, the capillary length was increased with the elevation of diastolic blood pressure, while the correlation was not found in pregnant women who exercised.

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A new definition of gestational hypertension? New-onset blood pressures of 130 to 139/80 to 89 mm Hg after 20 weeks of gestation

Cited by 22 publications

References 16 publications

The relationship between high–normal blood pressure in the first half of pregnancy and the risk of hypertensive disease of pregnancy

The relationship between high–normal blood pressure in the first half of pregnancy and the risk of hypertensive disease of pregnancy

Definición de la presión arterial normal a las 11-14 semanas de gestación según riesgo

The research of correlation between blood pressure and nailfold capillary parameters in exercising and non-exercising pregnant women

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