Sympathovagal Imbalance, Decreased Baroreflex Sensitivity and Increased Myocardial Work Stress in Pregnant Women with Risk of Developing Gestational Hypertension: A Preliminary Report

Abstract

Background and Aim: Though the mechanisms responsible for the pathogenesis of Gestational Hypertension (GHT) are unclear, it has been reported that the disease is characterized by low circulating volume and high vascular resistance. The increased peripheral vascular resistance is caused due to sympathetic overactivity which in turn causes the increase in blood pressure and Cardiovascular risk (CV). Therefore, in the present study, we aimed to study the sympathovagal imbalance, Baroreflex Sensitivity (BRS) and Rate Pressured Product (RPP) in pregnant women with risk of developing GHT during their first and third trimesters of gestation. Methods: Heart Rate (HR), Systolic and Diastolic Blood Pressure (SBP, DBP) were measured. Rate-pressure product was calculated using SBP and HR. Spectral analysis of Heart Rate Variability (HRV), Blood Pressure Variability (BPV) including BRS were assessed in a group of pregnant women (n=18) with risk factors for GHT at 16 th week and 36th week of their gestation. Parameters were compared after 36 th week with 16th weeks and analyzed. Results: It was observed that the ratio of low-frequency to high-frequency power (LF-HF ratio) of HRV was significantly increased at 36 th week of pregnancy compared with 16 th week. There was decreased BRS at 36 th week of pregnancy in risk of GHT. Significant increase in RPP was seen at 36 th week of pregnant women with risk of developing GHT when compared with 16 th of gestation. Conclusion: In the present study we conclude that there is sympathovagal imbalance in pregnant women with risk of developing GHT. Also reduced BRS and increased RPP were seen in these subjects indicating that there was increased CV risk in these patients.

Assessment of a short-course yoga practice on cardiometabolic risks, fetomaternal outcomes and psychophysical health in gestational diabetes mellitus

“…With seven to ten days of yoga practice, blood glucose, heart rate, blood pressure and RPP were substantially reduced in GDM women (Table 2). RPP is the measure of myocardial work stress and increased RPP is considered as the increased cardiovascular risk (20,21). With yoga intervention, heart rate and blood pressure were decreased, and consequently the RPP was decreased, which indicates that the risk of cardiovascular disease is decreased following a very short-course of intervention.…”

Association of Hemoglobin during First Trimester and its Relation to Pregnancy-Induced Hypertension in Indian Women

“…Approximately, 5-8% of pregnant women globally and 5-15% of pregnant women in India are affected by pregnancy induced hypertension. [5,6] Race and ethnicity of women play a significant role in prevalence of pregnancy induced hypertension. Approximately, in 6-10% of diagnosed cases of PIH, complications are seen.…”

“…Increased vascular resistance in PIH is mainly due to increased sympathetic tone. [5] Endothelial dysfunctions along with altered blood concentration have been documented as a diagnostic tool for early detection of pregnancy induced hypertension. [8] During first trimester of pregnancy, hemoglobin is responsible for change in blood viscosity and blood concentration.…”