Sampling requirements for the tolerance-hyperbaric test in the diagnosis of hypertension in pregnancy

D AYALA
2003 American Journal of Hypertension  
Aims: To compare BP values measured by ABPM with those of isolated office BP, to establish a BP standard of normalcy at each of the three trimesters of pregnancy, and to examine and compare characteristics of circadian variability in the BP of clinically healthy pregnant women with those of women with cronic hypertension or preeclampsia. Methods: First trimester pregnant women underwent one 24-h ABPM at each trimester; mean BP values were calculated. Sleep hypertension was defined from
more » ... y published studies. Results: 24-h ABPM was undertaken in 48 women, with a mean age of 32,2Ϯ5,1 years. 36 (75%) had chronic hypertension, 21% a history of preeclampsia on previous pregnancies and 23% were previously healthy. 10 women (20,8%) developed preeclampsia. Comparing isolated office BP values with those measured by ABPM (gold standard) we got the following results: sensitivity 83,3%, specificity 78,6%, positive predictive value (PPV) 35,7%,negative predictive value (NPV) 97,1% Regarding uncomplicated pregnancies in healthy women, we got the patterns of ambulatory BP: in this study, unlike other reports where both SP and DP gradually return to nonpregnant levels, DP and nighttime SP tend to stay stable. As compared to uncomplicated pregnancies in healthy women, a statistically significant elevation of the circadian rhythm-adjusted mean of blood pressure is found in pregnancies with preeclampsia in all trimesters (pϽ0,01) for both systolic and diastolic BP. Regarding sleep hypertension we got the results described on table I Positive isolated office BP measures should always be confirmed with ABPM . Normal office BP values are most probably correct. Regarding uncomplicated pregnancies in healthy women, BP patterns do not match previous studies and will be reanalysed with a larger population. There is an elevation of the mean BP values in the PE group which is statistically significant through all the trimesters. If we compare the PE group to healthy ϩ CCH group, BP elevation is only significant in the 1 st trimester. There is a high prevalence of sleep hypertension in women with preeclampsia or CCH ,with a greater frequency of adverse pregnancy outcomes.
doi:10.1016/s0895-7061(03)00785-4 fatcat:qe6i2cpvs5aa3luvpxrmg24rba