title: Coupling of heart rate and systolic blood pressure in hypertensive pregnancy.
abstract: BACKGROUND
  This article is part of the Focus Theme of Methods of Information in Medicine on "Biosignal Interpretation: Advanced Methods for Studying Cardiovascular and Respiratory Systems".
  
  
  BACKGROUND
  Hypertensive pregnancy disorders affect 6 - 8 percent of all pregnancies and can result in severe complications for both the mother and the fetus.
  
  
  OBJECTIVE
  The aim of this study was to improve risk stratification of pregnant women suffering from hypertension and pre-eclampsia (PE) by applying bivariate Segmented Poincaré plot analysis (BSPPA).
  
  
  METHODS
  From 35 pregnant women suffering from chronic hypertension, gestational hypertension and PE, 30 minutes of noninvasive systolic blood pressure and beat- to-beat intervals were continuously recorded and analyzed by applying BSPPA to quantify their couplings.
  
  
  RESULTS
  We revealed significant different couplings between chronic hypertension (CH), gestational hypertension and PE, indicating that cardiovascular regulation can be considerably altered depending on the type of hypertensive disorder. The optimal multivariate set of two BSPPA indices was determined which distinguish best between CH and PE. It achieved a sensitivity of 100%, a specificity of 77.8% and an area under the receiver operator characteristic curve of 90.8%.
  
  
  CONCLUSIONS
  The BSPPA method a) provides improved risk stratification for pregnant women suffering from hypertension and PE, b) increases the ability to diagnose pathological changes, and c) could contribute substantially to the differential diagnosis of hypertensive pregnancy disorders.
authors: Prof. Dr. Andreas Voss, Department of Medical Engineering and Biotechnology, University of Applied Sciences Jena, Carl-Zeiss-Promenade 2, 07745 Jena, Germany, E-mail: andreas.voss@fh-jena.de.
authors: A
authors: A
authors: Voss
authors: C
authors: C
authors: Fischer
authors: R
authors: R
authors: Schroeder
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D015924:Blood Pressure Monitors / Q000706:statistics & numerical data*; D003196:Computer Graphics; D004562:Electrocardiography / Q000706:statistics & numerical data*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis* / Q000503:physiopathology; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000503:physiopathology; D011247:Pregnancy; D018570:Risk Assessment / Q000706:statistics & numerical data*; D012815:Signal Processing, Computer-Assisted; D055815:Young Adult
keywords: Poincaré plot analysis; blood pressure; coupling; heart rate variability; hypertensive pregnancy disorders; nonlinear dynamics