Management of hypertension in pregnancy — prevention, diagnosis, treatment and long-term prognosis. A position statement of the Polish Society of Hypertension, Polish Cardiac Society and Polish Society of Gynaecologists and Obstetricians

Prejbisz, Aleksander; Dobrowolski, Piotr; Kosiński, Przemysław; Bomba‐Opoń, Dorota; Adamczak, Marcin; Bekiesińska‐Figatowska, Monika; Kądziela, Jacek; Konopka, Anna; Kostka-Jeziorny, Katarzyna; Kurnatowska, Ilona; Leszczyńska‐Gorzelak, Bożena; Litwin, Mieczysław; Olszanecka, Agnieszka; Orczykowski, Michał; Poniedziałek‐Czajkowska, Elżbieta; Sobieszczańska−Małek, Małgorzata; Stolarz‐Skrzypek, Katarzyna; Szczepaniak‐Chicheł, Ludwina; Szyndler, Anna; Wolf, Jacek; Wielgoś, Mirosław; Hoffmań, Piotr; Januszewicz, Andrzej

doi:10.5603/ah.a2019.0011

Cited by 13 publications

(17 citation statements)

References 218 publications

(398 reference statements)

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“…We found that BP in euthyroid patients with HTN was affected by indicators that are common risk factors for CVD [9,29,30]. Similar data were obtained in the Hordaland Health Study [8].…”

Section: Discussionsupporting

confidence: 82%

Factors affecting blood pressure in patients with arterial hypertension and subclinical hypothyroidism

Radchenko

Kolesnikova

2021

Arterial Hypertension

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Background:The aim our study was to identify factors affecting blood pressure in patients with hypertension (HTN) and subclinical hypothyroidism (SH). Material and methods: One hundred and thirty-eight patients aged from 25 to 59 years were examined and divided into control group (n = 30), euthyroid patients with HTN (n = 45) and patients with HTN in combination with SH (n = 63). The levels of tumor necrosis factor-a, C-reactive protein, total hydroperoxide content, total antioxidant activity, total superoxide dismutase activity and sirtuin 1 were measured in addition to complete blood count and routine biochemical tests. The Kruskal-Wallis H test was used to test whether there was a significant difference between the independent and its dependent variables. Results: Fewer factors affected systolic and diastolic blood pressure in patients with HTN and SH compared with euthyroid patients. These included age, waist circumference, insulin, triglycerides, very high-density lipoprotein cholesterol, and TAA. The opposite results were found in relation to the increase in pulse pressure: significant effects of gender, hemoglobin, alkaline phosphatase were observed in patients with SH and only the level of ACT had a significant influence in euthyroid patients. Conclusions: Factors associated with blood pressure and their overall number differed among patients with SH and HTN compared with euthyroid patients with HTN. Such results may be due to changes in anthropometric parameters, metabolic profile and oxidative status in patients with concomitant SH.

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“…We found that BP in euthyroid patients with HTN was affected by indicators that are common risk factors for CVD [9,29,30]. Similar data were obtained in the Hordaland Health Study [8].…”

Section: Discussionsupporting

confidence: 82%

Factors affecting blood pressure in patients with arterial hypertension and subclinical hypothyroidism

Radchenko

Kolesnikova

2021

Arterial Hypertension

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“…The study included 70 healthy pregnant euthyroid women aged 30.53±4.51 (mean±SD) years (range 19–47 years), at 32.38±4.25 weeks of gestation and 22 healthy non-pregnant women aged 33.08±8.72 years (range 19–44 years). According to the current guidelines 13 14 , the upper acceptable limit of blood pressure was 140/90 mmHg, though in practice mean blood pressure of our study subjects was about 110–120/60–80 mmHg.…”

Section: Methodsmentioning

confidence: 68%

Establishing Reference Ranges for Aldosterone, Renin and Aldosterone-to-Renin Ratio for Women in the Third-Trimester of Pregnancy

Lewandowski

Tadros-Zins

Horzelski

et al. 2022

Exp Clin Endocrinol Diabetes

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Objective Diagnosis of primary hyperaldosteronism in pregnancy is complicated due to lack of reference ranges for aldosterone, renin and aldosterone-to-renin ratio. We have endeavoured to establish third-trimester reference ranges for the above-mentioned parameters. Design & Patients We performed postural tests for aldosterone and renin (chemiluminescence immunoassay Liason® DiaSorin Inc., Italy) in 70 healthy pregnant women (age 30.53±4.51 years), at 32.38±4.25 weeks of gestation and in 22 non-pregnant healthy women (age 33.08±8.72 years). Results Aldosterone reference ranges were 6.51–73.97 ng/dl and 12.33–86.38 ng/dl, for supine and upright positions, respectively and that for renin were 6.25–59.36 µIU/ml and 11.12–82.55 µIU/ml, respectively. Aldosterone and renin concentrations were higher in an upright position (p=0.000459 and p=0.00011, respectively). In contrast, aldosterone-to-renin ratio was not affected by posture (i. e. 0.497–3.084 ng/dl/µIU/ml versus 0.457–3.06 ng/dl/µIU/ml, p=0.12), but was higher (p=0.00081) than in non-pregnant controls. In comparison to manufacturer-provided non-pregnant reference range, supine aldosterone concentrations increased by 556% (lower cut-off) and 313% (upper cut-off), while upright aldosterone concentrations increased by 558% (lower cut-off) and 244% (upper cut-off). The reference range for supine renin concentrations increased by 223% (lower cut-off) and 48.7% (upper cut-off), while upright renin concentrations increased by 253% (lower cut-off) and 79% (upper cut-off). Conclusions There is an upward shift in aldosterone and renin reference ranges in the third-trimester of pregnancy accompanied by an increase in an aldosterone-to-renin ratio, that is not influenced by posture. It remains to be established whether the aldosterone-to-renin ratio may be used as a screening tool for primary hyperaldosteronism in pregnancy.

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“…Maternal multiple organ failure was diagnosed in case of alteration of two or more organs with a score of ≥3 according to Sequential Organ Failure Assessment Score [ 17 ]. Hypertension and PE were diagnosed according to the guidelines of the Polish Society of Obstetricians and Gynecologists [ 18 ]. Body mass index (BMI) was calculated by dividing as the actual body mass by the square of the body height.…”

Section: Methodsmentioning

confidence: 99%

sFlt-1/PlGF Ratio Is Not a Good Predictor of Severe COVID-19 nor of Adverse Outcome in Pregnant Women with SARS-CoV-2 Infection—A Case-Control Study

Malicka

Szymusik

Rebizant

et al. 2022

IJERPH

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Background: Elevated serum levels of sFlt-1 were found in non-pregnant severe COVID-19 patients. The aim was to investigate sFlt-1/PlGF ratio as a predictor of severe disease and adverse outcome in pregnant women with COVID-19. Methods: A single-center case-control study was conducted in pregnant women with SARS-CoV-2 infection. SARS-CoV-2-negative pregnant women served as controls. Serum sFlt-1/PlGF ratio was assessed. The primary outcome was severe COVID-19 and the secondary outcome comprised adverse outcomes including severe COVID-19, intensive care unit admission, maternal multiple organ failure, preterm delivery, fetal demise, preeclampsia or hypertension diagnosed after COVID-19, maternal death. Results: 138 women with SARS-CoV-2 infection and 140 controls were included. sFlt-1/PlGF ratio was higher in infected patients (11.2 vs. 24; p < 0.01) and in women with severe disease (50.8 vs. 16.2; p < 0.01). However, it was similar in women with adverse and non-adverse outcome (29.8 vs. 20; p = 0.2). The AUC of sFlt-1/PlGF ratio was 0.66 (95% CI 0.56–0.76) for the prediction of severe COVID-19, and 0.72 (95% CI 0.63–0.79) for the prediction of adverse outcome. Conclusions: sFlt-1 and sFlt-1/PlGF ratio are related to SARS-CoV-2 infection and the severity of COVID-19 during pregnancy. However, sFlt-1/PlGF ratio is not a good predictor of severe COVID-19 or adverse outcome.

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Management of hypertension in pregnancy — prevention, diagnosis, treatment and long-term prognosis. A position statement of the Polish Society of Hypertension, Polish Cardiac Society and Polish Society of Gynaecologists and Obstetricians

Cited by 13 publications

References 218 publications

Factors affecting blood pressure in patients with arterial hypertension and subclinical hypothyroidism

Factors affecting blood pressure in patients with arterial hypertension and subclinical hypothyroidism

Establishing Reference Ranges for Aldosterone, Renin and Aldosterone-to-Renin Ratio for Women in the Third-Trimester of Pregnancy

sFlt-1/PlGF Ratio Is Not a Good Predictor of Severe COVID-19 nor of Adverse Outcome in Pregnant Women with SARS-CoV-2 Infection—A Case-Control Study

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