Association between pregnancy-related hypertension and severity of hypertension

Moreira, Leila Beltrami; Gus, M; Nunes, Guilherme Tavares; Gonçalves, Carla Beatrice Crivelaro; Martins, João; Wiehe, Mário; Fuchs, Flávio Danni

doi:10.1038/jhh.2008.140

Cited by 6 publications

(2 citation statements)

References 18 publications

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“…Hypertension occurring during pregnancy may lead to preeclampsia, a serious condition associated with substantial maternal and fetal morbidity and mortality (Solomon and Seely 2006). Hypertension during pregnancy may also predispose women to development or increased severity of future cardiovascular disease (Garovic and Hayman 2007; Moreira et al 2009). …”

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confidence: 99%

Low-Level Lead Exposure and Elevations in Blood Pressure during Pregnancy

Wells

Navas‐Acien

Herbstman

et al. 2011

Environ Health Perspect

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BackgroundLead exposure is associated with elevated blood pressure during pregnancy; however, the magnitude of this relationship at low exposure levels is unclear.ObjectivesOur goal was to determine the association between low-level lead exposure and blood pressure during late pregnancy.MethodsWe collected admission and maximum (based on systolic) blood pressures during labor and delivery among 285 women in Baltimore, Maryland. We measured umbilical cord blood lead using inductively coupled plasma mass spectrometry. Multivariable models were adjusted for age, race, median household income, parity, smoking during pregnancy, prepregnancy body mass index, and anemia. These models were used to calculate benchmark dose values.ResultsGeometric mean cord blood lead was 0.66 μg/dL (95% confidence interval, 0.61–0.70). Comparing blood pressure measurements between those in the highest and those in the lowest quartile of lead exposure, we observed a 6.87-mmHg (1.51–12.21 mmHg) increase in admission systolic blood pressure and a 4.40-mmHg (0.21–8.59 mmHg) increase in admission diastolic blood pressure after adjustment for confounders. Corresponding values for maximum blood pressure increase were 7.72 (1.83–13.60) and 8.33 (1.14–15.53) mmHg. Benchmark dose lower limit values for a 1-SD increase in blood pressure were < 2 μg/dL blood lead for all blood pressure end points.ConclusionsA significant association between low-level lead exposures and elevations in maternal blood pressure during labor and delivery can be observed at umbilical blood lead levels < 2 μg/dL.

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confidence: 99%

Low-Level Lead Exposure and Elevations in Blood Pressure during Pregnancy

Wells

Navas‐Acien

Herbstman

et al. 2011

Environ Health Perspect

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“…Through linear regression and funnel plots, we found that studies on HDP ( P = 0.4639) and PE ( P = 0.5380) had no publication bias ( Figure 4 ). Figure 5A shows that when omitting one of these studies ( 22 ), the sensitivity analysis of the HDP group showed an OR of 4.10 (95% CI 2.49–6.74), which was nearly the same outcome as the total pooled effect (OR 3.61, 95% CI 2.18–6.00). Similarly, when omitting other studies, women with HDP were at higher risk for developing chronic hypertension than healthy controls.…”

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confidence: 97%

The Association Between Hypertensive Disorders in Pregnancy and the Risk of Developing Chronic Hypertension

Wang

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveThis meta-analysis comprehensively evaluated the association between hypertensive disorders in pregnancy (HDP) and the risk of developing chronic hypertension and the associations between specific types of HDP, including preeclampsia (PE) and gestational hypertension (GH), and the risk of developing chronic hypertension.DesignSystematic review and meta-analysis.Data SourcesThe PubMed, Embase and Cochrane Library databases were searched from inception to August 20, 2021.MethodsDepending on heterogeneity, the combined odds ratio (OR) of the 95% confidence interval (CI) was obtained with a random-effects or fixed-effects model. We used meta-regression analysis to explore the sources of heterogeneity. We analyzed the OR value after adjusting for age and BMI at recruitment, prepregnancy BMI, age at first delivery, and other factors. Additionally, we evaluated the results of the subgroup analysis by the year of publication (< 2016, ≥ 2016), study design, sample size (< 500, ≥ 500), region (North and South America, Europe, and other regions) and NOS score (< 7, ≥ 7).ResultsOur systematic review and meta-analysis comprehensively explored the relationships between HDP, GH, and PE and chronic hypertension. Twenty-one articles that included 634,293 patients were included. The results of this systematic review and meta-analysis suggested that women with a history of HDP are almost 3.6 times more likely to develop chronic hypertension than those without a history of HDP, women with a history of GH are almost 6.2 times more likely to develop chronic hypertension than those without a history of GH, and women with a history of PE are almost 3.2 times more likely to develop chronic hypertension than those without a history of PE. In addition, we further calculated the probability of developing chronic hypertension among patients with HDP or PE after adjusting for age and BMI at recruitment, prepregnancy BMI, age at first delivery, and other factors. The results suggested that women with a history of HDP are almost 2.47 times more likely to develop chronic hypertension than those without a history of HDP and that women with a history of PE are almost 3.78 times more likely to develop chronic hypertension than those without a history of PE. People in Asian countries are more likely to develop chronic hypertension after HDP or PE, while American people are not at high relative risk.ConclusionThese findings suggest that HDP, GH, and PE increase the likelihood of developing chronic hypertension. After adjustment for age and BMI at recruitment, prepregnancy BMI, age at first delivery, and other factors, patients with HDP or PE were still more likely to develop chronic hypertension. HDP may be a risk factor for chronic hypertension, independent of other risk factors. GH and PE, as types of HDP, may also be risk factors for chronic hypertension.Systematic Review Registration[www.ClinicalTrials.gov], identifier [CRD42021238599].

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Serotonin risk factors for the development of hypertension in pregnancy

Rudman

Mustapić

Košec

et al. 2014

Arch Gynecol Obstet

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The results confirm alterations in the peripheral 5-HT system in pregnancy-induced hypertension. Low platelet 5-HT concentration is a common feature of both PIH and pre-eclampsia. The results did not support the hypothesis that hypertension in pregnancy is a trait associated with polymorphic variants of the HTR2A and SLC6A4 or that they have a role in the predisposition to hypertensive disorders in pregnancy. The further studies are necessary to elucidate the role of 5-HT and genetic factors in the development of hypertensive disorders in pregnancy.

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Association between pregnancy-related hypertension and severity of hypertension

Cited by 6 publications

References 18 publications

Low-Level Lead Exposure and Elevations in Blood Pressure during Pregnancy

Low-Level Lead Exposure and Elevations in Blood Pressure during Pregnancy

The Association Between Hypertensive Disorders in Pregnancy and the Risk of Developing Chronic Hypertension

Serotonin risk factors for the development of hypertension in pregnancy

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