Nocturnal hypertension in high-risk mid-pregnancies predicts pre-eclampsia/eclampsia
A recent study suggests that nocturnal hypertension at high-risk mid-pregnancy is common and strongly predicts pre-eclampsia/eclampsia (PEEC). Such risk was two times higher in women not taking acetylsalicylic acid (ASA).
Eighty-seven women (mean age 31±7 years) with 23±2 weeks of pregnancy were included in the study. The corresponding prevalence of office and ambulatory blood pressure monitoring (ABPM) hypertension was 13.8 percent and 40.2 percent. There was a low concordance between these two diagnoses of hypertension (κ, 0.170; p=0.044).
Nocturnal hypertension was more frequent than diurnal hypertension (35.6 percent vs 26.4 percent). Nocturnal hypertension significantly elevated the relative risk of PEEC (odds ratio [OR], 5.32; 95 percent CI, 1.48–19.10).
PEEC risk associated with diurnal hypertension was not statistically significant. When both diurnal and nocturnal hypertension were included in the same model, only the latter significantly predicted PEEC (p=0.012). Furthermore, women not taking ASA had higher relative risk attributed to nocturnal hypertension (OR, 11.40; 2.35–55.25).
Women coursing high-risk mid-pregnancies participated in this study, which sought to test whether hypertension detected by ABPM was a useful predictor for PEEC. Office BP, taken by a specialized nurse after a 15-min interview, was estimated as the mean of three values. Office hypertension was defined as ≥140/90 mm Hg. An ABPM was initiated immediately after.
Diurnal hypertension referred to ABPM ≥135/85 mm Hg during daily activities, while nocturnal hypertension was defined as ABPM ≥120/70 mm Hg during night rest. The investigators used logistic regression to estimate the adjusted PEEC risk.