title: Significance of masked and nocturnal hypertension in normotensive women coursing a high-risk pregnancy.
abstract: The aim was to evaluate the prevalence of nocturnal and masked hypertension and the prognostic values of these blood pressure (BP) abnormalities in normotensive women coursing a high-risk pregnancy.
  
  
  
  The study was performed in pregnant women with 20 or more weeks of gestation coursing a high-risk pregnancy, sent to a specialized hypertension department to perform a prospective defined protocol of BP evaluation. Women with office BP at least 140/90 mmHg were excluded. An ambulatory monitoring of BP was performed to identify masked and nocturnal hypertension (defined according to the current guidelines). The adjusted risk for development of preeclampsia/eclampsia (PEEC) was estimated using logistic regression. The ability of SBP and DBP to identify risk of PEEC was estimated using area under the receiver-operating characteristic curves.
  
  
  
  Eighty-seven women (29 ± 7 years old, 30 ± 5 weeks of pregnancy) were included in this analysis. The prevalence of masked hypertension was 33.3%. Nocturnal hypertension was found in 42.5% of the women. Remarkably, 27.0% of the women with nocturnal hypertension had normal 24-h values according to ambulatory BP monitoring. Twenty-two patients developed PEEC; adjusted relative risks increased with the presence of nocturnal (odds ratio = 4.72, 95% confidence interval 1.25-19.43, P = 0.023) or masked hypertension (odds ratio = 7.81, 95% confidence interval 2.6-22.86, P = 0.001). Nocturnal SBP and DBP had the highest abilities to predict PEEC (area under the curve = 0.77 and 0.80, respectively).
  
  
  
  Masked and nocturnal hypertension are frequent findings in normotensive women coursing a high-risk pregnancy, and their presence implies an increased risk to develop PEEC.
authors.affiliation: aHospital Universitario Gral. San Martín bFacultad de Ciencias Médicas, UNLP, La Plata, Argentina.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Salazar
authors.forename: Walter G
authors.initials: WG
authors.lastname: Espeche
authors.forename: Betty C
authors.initials: BC
authors.lastname: Leiva Sisnieguez
authors.forename: Eduardo
authors.initials: E
authors.lastname: Balbín
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Leiva Sisnieguez
authors.forename: Rodolfo N
authors.initials: RN
authors.lastname: Stavile
authors.forename: Carlos E
authors.initials: CE
authors.lastname: March
authors.forename: Florencia
authors.initials: F
authors.lastname: Grassi
authors.forename: Claudia
authors.initials: C
authors.lastname: Santillan
authors.forename: Susana
authors.initials: S
authors.lastname: Cor
authors.forename: Horacio A
authors.initials: HA
authors.lastname: Carbajal
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D055815:Young Adult