title: Beat-to-beat heart rate and blood pressure variability and hypertensive disease in pregnancy.
abstract: OBJECTIVE
  The aim of this study is to determine the relationship between heart rate and/or blood pressure variability, measured at 28 weeks' gestation, and the incidence of pregnancy-induced hypertension or preeclampsia.
  
  
  METHODS
  Secondary analysis of data from a prospectively enrolled cohort of 385 active military women in whom spectral analysis of continuous heart rate and variability was measured at 28 weeks' gestation. The primary outcome was the predictive value of spectral analysis of heart rate and blood pressure for hypertensive diseases of pregnancy.
  
  
  RESULTS
  High-frequency heart rate variability was reduced and low-frequency variability of systolic and diastolic blood pressure increased in women who would develop pregnancy-induced hypertension but not preeclampsia. Low-frequency variability of diastolic blood pressure remained a significant predictor of pregnancy-induced hypertension but not preeclampsia after adjustment for age, weight, and blood pressure in a multivariate model.
  
  
  CONCLUSIONS
  Early identification of pregnancy-induced hypertension can facilitate treatment to avoid maternal morbidity. Understanding the physiological underpinnings of the two very different diseases may lead to improved treatment and prevention. If proven effective in a broader population, the ability to differentiate pregnancy-induced hypertension from preeclampsia may reduce unnecessary iatrogenic interventions or inappropriate preterm delivery.
authors.affiliation: Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, San Francisco, California.
authors.forename: Pamela
authors.initials: P
authors.lastname: Flood
authors.affiliation: Department of Behavioral Medicine, Columbia University, New York, New York.
authors.forename: Paula
authors.initials: P
authors.lastname: McKinley
authors.affiliation: Department of Psychiatry, Behavioral Medicine and Developmental Neuroscience, Columbia University, New York, New York.
authors.forename: Catherine
authors.initials: C
authors.lastname: Monk
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Lisandro D
authors.initials: LD
authors.lastname: Colantonio
authors.affiliation: Department of Obstetrics and Gynecology, Temple University, Philadelphia, Pennsylvania.
authors.forename: Laura
authors.initials: L
authors.lastname: Goetzl
authors.affiliation: National Institutes of Health/National Cancer Institute, Division of Cancer Epidemiology & Genetics, Radiation Epidemiology Branch Bethesda, Maryland.
authors.forename: Maureen
authors.initials: M
authors.lastname: Hatch
authors.affiliation: Department of Behavioral Medicine, Columbia University, New York, New York.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Sloan
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D005865:Gestational Age; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000503:physiopathology*; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology*; D055815:Young Adult