Circadian variation of blood-pressure in pregnancy

Murnaghan, G. A.; Mitchell, R. H.; Ruff, Stanley J.

doi:10.1007/978-94-009-8697-8_16

Cited by 13 publications

(10 citation statements)

References 2 publications

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“…In preeclampsia there is variable sensitivity of the blood vessels to vasoactive substances like noradrenaline and angiotensin2. A reduced fall in blood pressure is seen in severe preeclampsia during sleep and in some pateints the reverse of this pattern has been demonstrated [10,14]. In the present study, which included women with mild to moderate preeclampsia, the day-time mean arterial blood pressure and mean diastolic blood pressure were higher compared with the corresponding blood pressure values at night.…”

Section: Discussionsupporting

confidence: 54%

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Automated 24-hour ambulatory blood pressure monitoring in preeclampsia

Montán¹,

Choolani²,

Arulkumaran³

et al. 1995

Jpme

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A prospective controlled study was designed to compare automated 24-hour ambulatory blood pressure monitoring with intermittent blood pressure recordings obtained using a sphymomanometer. Blood pressure was measured in 20 hospitalized preeclamptic women in the third trimester. Data obtained using the Spacelabs automated blood pressure monitor was recorded over a period of 24 hours, and thereafter stored and processed in a computer. During the same 24 hour period, blood pressure and heart rate were measured by experienced staff at 07.00, 10.00, 13.00, 15.00, 18.00 and 21.00 hours, with the patient in a semi-recumbent position using a conventional mercury sphygmomanometer with a cuff of appropriate size. Korotkoff phase 5 was used as the indicator of diastolic blood pressure in all recordings by the staff. The main outcome measures were systolic and diastolic blood pressure, mean arterial blood pressure and maternal heart rate. Automated ambulatory monitoring was well tolerated and gave 91.6% successful readings. The mean differences between the blood pressure readings recorded by the monitor and of intermittent mercury sphygmomanometry during daytime were 0.7 (95% confidence interval -2.6 to 4.0) mmHg for the mean arterial blood pressure, -1.7 (95% confidence interval -6.8 to 3.5) mmHg for the systolic blood pressure, and 1.9 (95% confidence interval -2.2 to 6.0) mmHg for the diastolic blood pressure. The mean differences between day-time and night-time monitored blood pressures were 4.3 (95% confidence interval 0.8 to 7.8) mmHg, 4.6 (95% confidence interval 2.0 to 7.2) mmHg, and 4.4 (95% confidence interval 1.5 to 7.2) mmHg, respectively. The number of patients diagnosed as being hypertensive was similar whether automated blood pressure monitor or mercury sphymomanometry was used. Mean maternal heart rate recorded by the monitor or by the staff did not differ. Automated ambulatory blood pressure monitoring is reliable and might improve our understanding of the dynamic changes in blood pressure in pre-eclamptic women and may be a more suitable method to assess the blood pressure control achieved by different drugs.

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Section: Discussionsupporting

confidence: 54%

“…A similar pattern is seen in pregnancy both in normotensive and in chronically hypertensive women [10,14,15,16]. In preeclampsia there is variable sensitivity of the blood vessels to vasoactive substances like noradrenaline and angiotensin2.…”

Section: Discussionsupporting

confidence: 54%

Automated 24-hour ambulatory blood pressure monitoring in preeclampsia

Montán¹,

Choolani²,

Arulkumaran³

et al. 1995

Jpme

View full text Add to dashboard Cite

show abstract

“…The percentage drop in systolic blood pressure was significantly less in the pre‐eclamptic group. It has long been known that diurnal variation is altered in established pre‐eclampsia 21–23 . Indeed, in the most severe cases of pre‐eclampsia reversal of the normal diurnal pattern has been recorded 24,25 .…”

Section: Discussionmentioning

confidence: 99%

Can 24‐hour ambulatory blood pressure measurement predict the development of hypertension in primigravidae?

Higgins

Walshe

Halligan

et al. 1997

BJOG

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Objective To assess the role of 24-hour ambulatory blood pressure measurement in the mid-second Design Prospective intervention. Setting The Rotunda Hospital, Dublin. Participants One thousand one hundred and two healthy primigravid women, Intervention 24-hour ambulatory blood pressure measurement at 18 to 24 weeks of gestation. Main outcome measures The development of pre-eclampsia or gestational hypertension. Results A total of 1048 women had sufficient readings to be included in the final analysis. Of these, 23 (2.2%) developed pre-eclampsia, 64 (6.1%) developed gestational hypertension and 96 1 (91.7%) remained normotensive. Significantly higher ambulatory blood pressures were recorded in both the pre-eclamptic and gestational hypertensive group compared with the normotensive group. In addition, the gestational hypertensive group had significantly higher clinically measured blood pressure compared with the normotensive group. There were no differences between the preeclamptic and the gestational hypertensive group for any of the blood pressure parameters analysed. The best overall predictor for pre-eclampsia was 24-hour mean diastolic pressure which using a cutoff level of 71 mmHg gave a test with a sensitivity of only 22% and a positive predictive value of 15%.Conclusion Because the absolute differences are small and the overlap between the hypertensive and normotensive groups large, ambulatory blood pressure measurement, in a healthy primigravid population, between 18 and 24 weeks of gestation is not a useful predictor of hypertension.trimester as a predictive test for the development of hypertension in pregnancy.

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“…Igualmente, observa-se diminuição linear da pressão arterial sistólica, diastólica e média até a 22 a semana de gestação, seguida por aumento progressivo até o dia do parto [17][18][19] . Variações da pressão arterial na pré-eclâmpsia têm sido reconhecidas há muito tempo.…”

Section: Grávidasunclassified

I Diretrizes para o Uso da Monitorização Residencial da Pressão Arterial

2001

Arq. Bras. Cardiol.

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Circadian variation of blood-pressure in pregnancy

Cited by 13 publications

References 2 publications

Automated 24-hour ambulatory blood pressure monitoring in preeclampsia

Automated 24-hour ambulatory blood pressure monitoring in preeclampsia

Can 24‐hour ambulatory blood pressure measurement predict the development of hypertension in primigravidae?

I Diretrizes para o Uso da Monitorização Residencial da Pressão Arterial

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