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Significance of Nocturnal Diastolic Blood Pressure in Predicting Outcomes in Hypertensive Disorders of Pregnancy
Session:
Sessão de Posters 07 - Hipertensão arterial
Speaker:
João Faia
Congress:
CPC 2024
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.14 Risk Factors and Prevention - Other
Session Type:
Cartazes
FP Number:
---
Authors:
Carlos Costa; Mesquita Bastos; Adriana Pacheco; Diana Carvalho; Simão Carvalho; Tiago Aguiar; Tiago Adrega; Carlos Costa
Abstract
<p>Background<br /> Ambulatory blood pressure monitoring (ABPM) has become increasingly important in diagnosing and caring for pregnant hypertensives.<br /> Objective<br /> To determine which blood pressure values obtained through ABPM better correlate with adverse events for pregnant women and newborns.<br /> Methods and Results<br /> The study included 204 pregnant women diagnosed with gestational hypertension or chronic hypertension. It was considered an event: preeclampsia/eclampsia (PEEC), fetal/neonatal death, prematurity, low weight at birth, gestational diabetes and maternal death. All systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurements, both casual and ambulatory, were statistically associated with the global event and PEEC. After adjusting for confounding variables (casual SBP, casual DBP, age, BMI, risk factors for preeclampsia, medication and gestational age on ABPM), casual SBP and DBP no longer showed a significant association with the events. Nocturnal blood pressure values have a greater predictive value compared to daytime values. In comparison with nocturnal SBP, nocturnal DBP correlates more significantly with the global event [HR 1,054 (95%CI 1,034;1,075) vs HR 1,025 (95%CI 1,012;1,037)], PEEC [HR 1,066 (95%CI 1,039;1,094) vs HR 1,035 (95%CI 1,019;1,051)], low birth weight (HR 1,088 (95%CI 1,053;1,125) vs HR 1,042 (95%CI 1,023;1,062)] and prematurity [HR 1,079 (95%CI 1,042;1,117) vs HR 1,038 (95%CI 1,017;1,060)]. DBP dipping is more strongly associated with global events than SBP dipping [HR 0.940 (95%CI 0.885;0.999) vs HR 1.017 (95%CI 0.948;1.091)].<br /> Conclusions<br /> In a cohort of hypertensive pregnant women, nocturnal DBP showed the strongest correlation with events. The diastolic dipping pattern correlates more significantly with global event than the systolic pattern.</p>
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