Blood Pressure Measurement for Hypertension in Pregnancy

Dehaeck, Ulrike; Thurston, Jackie; Gibson, Paul; Stephanson, Kirk; Ross, Sue

doi:10.1016/s1701-2163(16)34476-0

Cited by 18 publications

(8 citation statements)

References 18 publications

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“…A recent Canadian survey among physicians and obstetricians sought to determine whether any measures were taken to discriminate between pregnant women with true hypertension and WCH in routine clinical practice . Approximately 80% of both groups said they paid routine attention to this issue, the majority using some form of home BP measurement, with less than one‐quarter of the whole group using ABPM.…”

Section: White‐coat Hypertension In Pregnancymentioning

confidence: 99%

“…35 A recent Canadian survey among physicians and obstetricians sought to determine whether any measures were taken to discriminate between pregnant women with true hypertension and WCH in routine clinical practice. 36 Approximately 80% of both groups said they paid routine attention to this issue, the majority using some form of home BP measurement, with less than one-quarter of the whole group using ABPM. It is not quite clear at what gestation these measurements were made, but it implies that ABPM and automated home BP measurements are becoming part of antenatal care for hypertensive pregnant women.…”

Section: White-coat Hypertension In Pregnancymentioning

confidence: 99%

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Is there a role for ambulatory blood pressure monitoring in pregnancy?

Brown

2013

Clin Exp Pharmacol Physiol

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1. Ambulatory blood pressure monitoring (ABPM) has been used in pregnancy for just over 20 years now and is generally well tolerated. Normal values have been established for different gestations; these are slightly higher than conventional blood pressure (BP) in normal pregnancy, presumably reflecting greater activity during the 24 h of ABPM recordings. 2. Ambulatory blood pressure monitoring is a better predictor than conventional BP for the development of pre-eclampsia and fetal growth restriction, but it is not sensitive or specific enough to be recommended for these purposes in routine practice. 3. Studies of ABPM have shown that sleep hypertension is common in women with gestational hypertension or pre-eclampsia, but detecting this in routine clinical practice does not aid usual decision making in the pregnancy, including timing of delivery. 4. Studies using ABPM have found that pregnant women who are working outside the home have higher BP than non-working women, but these data should not be interpreted to mean that not working during pregnancy will prevent gestational hypertension or pre-eclampsia. 5. The best role for ABPM is to determine whether women with office hypertension in early pregnancy have true (usually essential) hypertension or white-coat hypertension. The latter can be managed without antihypertensives and pregnancy outcomes appear good, although possibly with a slightly increased incidence of pre-eclampsia. 6. Women who have had pre-eclampsia are at greater life-time risk for cardiovascular diseases; several years postpartum these women have slightly higher ABPM-measured BP than women who had normal pregnancies and a greater propensity to metabolic syndrome.

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Section: White‐coat Hypertension In Pregnancymentioning

confidence: 99%

Section: White-coat Hypertension In Pregnancymentioning

confidence: 99%

Is there a role for ambulatory blood pressure monitoring in pregnancy?

Brown

2013

Clin Exp Pharmacol Physiol

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“… 21 A subsequent survey, of Canadian obstetricians and primary care physicians, found that most used SMBP to check for WCH (where BP is higher in clinic than at home) rather than ambulatory BP monitoring. 22 …”

mentioning

confidence: 99%

How Do Home and Clinic Blood Pressure Readings Compare in Pregnancy?

Tucker¹,

Bankhead²,

Hodgkinson

et al. 2018

Hypertension

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“…Despite these limitations, our survey results are similar to those in a study conducted amongst obstetricians and family practice physicians who practice obstetrics in Alberta, Canada, which noted that 74% and 70% used home BP monitoring to identify hypertension in their pregnant women, respectively. 23 24-hour ABPM was only recommended by 12% of obstetricians and 26% of family physicians to identify hypertension. Interestingly, frequent office BP monitoring was preferred over self-monitoring for ongoing hypertension surveillance by both obstetricians and family practice physicians.…”

Section: Frequency Of Responses (%)mentioning

confidence: 99%

Out-of-office blood pressure measurement for the diagnosis of hypertension in pregnancy: Survey of Canadian Obstetric Medicine and Maternal Fetal Medicine specialists

et al. 2019

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Background Multiple hypertension guidelines recommend out-of-office measurements for the diagnosis of hypertension in non-pregnant adults, whereas pregnancy guidelines recommend in-office blood pressure measurements. The objective of our study was to determine how Canadian Obstetric Medicine and Maternal Fetal Medicine specialists measure blood pressure in pregnancy. Methods An email survey was sent to 69 Canadian Obstetric Medicine and Maternal Fetal Medicine specialists in academic centers across Canada to explore the practice patterns of blood pressure measurement in pregnant women. Results The response rate was 48%. The majority of respondents (63.6%) preferred office blood pressure measurement for diagnosing hypertension, but relied on home blood pressure readings for ongoing monitoring and management of hypertension during pregnancy (59.4%). The preferred method of out-of-office blood pressure measurement was home monitoring; 24-hour ambulatory blood pressure monitoring was not used due to limited availability and cost. Conclusions There is wide practice variation in methods of measuring blood pressure among Canadian specialists managing hypertension in pregnancy.

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Blood Pressure Measurement for Hypertension in Pregnancy

Cited by 18 publications

References 18 publications

Is there a role for ambulatory blood pressure monitoring in pregnancy?

Is there a role for ambulatory blood pressure monitoring in pregnancy?

How Do Home and Clinic Blood Pressure Readings Compare in Pregnancy?

Out-of-office blood pressure measurement for the diagnosis of hypertension in pregnancy: Survey of Canadian Obstetric Medicine and Maternal Fetal Medicine specialists

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