title: Twenty-four-hour ambulatory blood pressure monitor heart rate: a potential marker for gestational hypertension in at-risk women.
abstract: We prospectively correlated the 24-hour ambulatory blood pressure measurements (ABPM) to conventional sphygmomanometer blood pressure measurements (CSM) in women at risk for gestational hypertensive disorders (GHTNDs) and identified predictive factors from ABPM for GHTND. We analyzed 73 women with ≥ 1 risk factor for developing a GHTND. Using both the CSM and ABPM, the systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), and heart rate (HR) were measured for 24 hours during three periods (14 to 24 weeks; 24 to 32 weeks; and 33 weeks to delivery). Correlation between the CSM and ABPM lessened as pregnancy progressed. Seventeen (25%) of women developed a GHTND. MAP variability increased in the GHTND group versus those without a GHTND. The odds of developing a GHTND increased 1.5 times for every 1 beat per minute increase in the ABPM 24-hour HR at visit 1 and reversed by visit 3. In women at risk for a GHTND, CSM and ABPM correlate less well as pregnancy advances. HR changes in at-risk women may be a marker for the development of a GHTND and may reflect increased sympathetic activity and/or decreased baroreceptor sensitivity.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA. cjbooker@med.unc.edu
authors.forename: Corenthian J
authors.initials: CJ
authors.lastname: Booker
authors.forename: William C
authors.initials: WC
authors.lastname: Dodson
authors.forename: Allen R
authors.initials: AR
authors.lastname: Kunselman
authors.forename: John T
authors.initials: JT
authors.lastname: Repke
authors.forename: Richard S
authors.initials: RS
authors.lastname: Legro
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D005865:Gestational Age; D006339:Heart Rate; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis*; D007231:Infant, Newborn; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D019722:Sphygmomanometers; D055815:Young Adult