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Federación Mexicana de Ginecología y Obstetricia, A.C.

2014, Number 09

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Ginecol Obstet Mex 2014; 82 (09)

Circadian rhythm of blood pressure in patients with chronic hypertension and pregnancy

Rojo-Contreras W, Salazar-Páramo M, Parra-Carrillo JZ, Iñigo-Riesgo CA, Bonilla-Rosales I, Villa-Manzano AI, Canales-Muñoz JL

Language: Spanish
References: 19
Page: 604-612
PDF size: 348.25 Kb.


ABSTRACT

Background: Ambulatory blood pressure monitoring during 24 hours shows a blood pressure variability. The prevalence of chronic hyperten sion in pregnant women is 1-5%, so it is important to know the changes in blood pressure and cardiovascular risk and prevent complications to the mother and fetus.
Objetive: To know the circadian rhythm of the blood pressure in the chronic hypertensive pregnant patients, through the ambulatory blood pressure monitoring.
Material and methods: A cross-sectional and descriptive study included chronic hypertensive pregnant patients, with › 20 weeks of gestation. Assessment of factors related to gynaecologic characteristics, according to the inclusion criteria underwent a washout period of two weeks and they were monitored with a Spacelabs 90207 monitor blood pressure. Quantitative variables by Student t test, one-way ANOVA and Pearson correlation were analysed.
Results: 16 chronic hypertensive pregnant patients were included, whose ambulatory blood pressure monitoring for the systolic blood pressure in 24 hours averaged 117.12 ± 5.85 mmHg; 24 hours diastolic blood pressure 71.31 ± 5.89 mmHg; daytime systolic blood pressure 120.18 ± 5.75 mmHg, nocturnal systolic blood pressure 110.31 ± 8.41 mmHg; daytime diastolic blood pressure 75.43 ± 7.32 mmHg, nocturnal diastolic blood pressure 64.25 ± 8.27 mmHg. Significant differences between daytime and night time were found.
Conclusion: 56% of chronic hypertensive pregnant patients had no nocturnal reduction in systolic blood pressure and 43.75% had no nocturnal changes on diastolic blood pressure. The fact that 50% of patients were non-dippers force us to use long-action antihypertensive therapy and obtain control of the blood pressure for 24 hours.


REFERENCES

  1. August P, Lenz T, Ales KL, Druzin ML, et al. Longitudinal study of the renin-angiotensin-aldosterone system in hypertensive pregnant women: Deviations related to development of superimposed preeclampsia. Am J Obstet Gynecol 1990;163:1612-1621.

  2. O’ Brien E, Coats A, Owens P, Petrie J, et al. Use and interpretation of ambulatory blood pressure monitoring: recommendations of the British Hypertension Society. BMJ 2000;320:1128-1134.

  3. Parra-Carrillo JZ, Fonseca-Reyes S. Manual de monitoreo ambulatorio de la presión arterial. Centro Universitario de Ciencias de la Salud. 1ª ed. Guadalajara: Universidad de Guadalajara-Intersistemas, 2011;2.

  4. Coca A. Circadian rhytm and blood pressure control: physiological and pathophysiological factors. J Hypertens Suppl 1994;12:S13-S21.

  5. Gupta HP, Singh RK, Singh U, Mehrotra S, et al. Circadian pattern of blood pressure in normal pregnancy and preeclampsia. J Obstet Gynaecol India 2011;61:413-417.

  6. Sibai BM. Treatment of Hypertension in pregnant women. N England J Medicine 1996;335:257-265.

  7. Lindheimer MD, Roberts JM, Cunningham FG. Hipertensión en el embarazo. 2ª ed. México: McGraw-Hill-Interamericana, 2001;565-591.

  8. Magee LA, Ornstein MP, Von Dadelszen P. Fortnightly review: Management of hypertension in pregnancy. BMJ 1999;318:1332-1336.

  9. Sibai B, Lindheimer MD, Hauth J, Caritis S, et al. Risk factors for preeclampsia, abruptio placenta, and adverse neonatal outcome in women with chronic hypertension. N Engl J Med 1998;339:667-671.

  10. O’ Brien E, Mee F, Atkins N, Halligan A, et al. Accuracy of the SpaceLabs 90207 ambulatory blood pressure measuring system in normotensive pregnant women determined by the British Hypertension Society protocol. J Hypertens Suppl 1993;11:S282-S283.

  11. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol 2000;183:S1-S22.

  12. Ahued-Ahued JR, Fernández del Castillo SC, Bailón-Uriza R. Ginecología y obstetricia aplicadas. Segunda edición. México: El Manual Moderno, 2003;472-474.

  13. Shennan AH, Kissane J, de Swiet M. Validation of the spaceLabs 90207 ambulatory blood pressure monitor for use in pregnancy. Br J Obstet Gynaecol 1993;100:904- 908.

  14. Mallion JM, Baguet JP, Siché JP, Tremel F, et al. Clinical value of ambulatory blood pressure monitoring. J Hypertens 1999;17:585-595.

  15. Benedetto C, Zonca M, Marozio L, Dolci C, et al. Blood pressure patterns in normal pregnancy and in pregnancyinduced hypertension, preeclampsia, and chronic hypertension. Obstet Gynecol 1996;88:503-510.

  16. Browm MA, Robinson A, Bowyer L, Buddle ML, et al. Ambulatory blood pressure monitoring in pregnancy: What is normal? Am J Obstet Gynecol 1998;178:836-842.

  17. Shimada K, Kawamoto A, Matsubayashi K, Nishinaga M, et al. Diurnal blood pressure variations and silent cerebrovascular damage in elderly patients with hypertension. J Hypertens 1992;10:875-878.

  18. Imai Y, Abe K, Munakata M, Sakuma H, et al. Circadian blood pressure variations under different pathophysiological conditions. J Hypertens Suppl 1990;8:S125-132.

  19. Middeke M, Klüglich M, Holzgreve H. Circadian blood pressure rhythm in primary and secondary hypertension. Chronobiol Int 1991;8:451-459.




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