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Wilson MG, Bone JN, Slade LJ, Mistry HD, Singer J, Crozier SR, Godfrey KM, Baird J, von Dadelszen P, Magee LA. Blood pressure measurement and adverse pregnancy outcomes: A cohort study testing blood pressure variability and alternatives to 140/90 mmHg. BJOG 2024; 131:1006-1016. [PMID: 38054262 PMCID: PMC11256866 DOI: 10.1111/1471-0528.17724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/19/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVE To examine the association with adverse pregnancy outcomes of: (1) American College of Cardiology/American Heart Association blood pressure (BP) thresholds, and (2) visit-to-visit BP variability (BPV), adjusted for BP level. DESIGN An observational study. SETTING Analysis of data from the population-based UK Southampton Women's Survey (SWS). POPULATION OR SAMPLE 3003 SWS participants. METHODS Generalised estimating equations were used to estimate crude and adjusted relative risks (RRs) of adverse pregnancy outcomes by BP thresholds, and by BPV (as standard deviation [SD], average real variability [ARV] and variability independent of the mean [VIM]). Likelihood ratios (LRs) were calculated to evaluate diagnostic test properties, for BP at or above a threshold, compared with those below. MAIN OUTCOME MEASURES Gestational hypertension, severe hypertension, pre-eclampsia, preterm birth (PTB), small-for-gestational-age (SGA) infants, neonatal intensive care unit (NICU) admission. RESULTS A median of 11 BP measurements were included per participant. For BP at ≥20 weeks' gestation, higher BP was associated with more adverse pregnancy outcomes; however, only BP <140/90 mmHg was a good rule-out test (negative LR <0.20) for pre-eclampsia and BP ≥140/90 mmHg a good rule-in test (positive LR >8.00) for the condition. BP ≥160/110 mmHg could rule-in PTB, SGA infants and NICU admission (positive LR >5.0). Higher BPV (by SD, ARV, or VIM) was associated with gestational hypertension, severe hypertension, pre-eclampsia, PTB, SGA and NICU admission (adjusted RRs 1.05-1.39). CONCLUSIONS While our findings do not support lowering the BP threshold for pregnancy hypertension, they suggest BPV could be useful to identify elevated risk of adverse outcomes.
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Affiliation(s)
- Milly G. Wilson
- Department of Women and Children's Health, Faculty of Medicine, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Jeffrey N. Bone
- British Columbia Children's Hospital Research InstituteUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Department of Obstetrics and GynaecologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Laura J. Slade
- Robinson Research InstituteThe University of AdelaideAdelaideSouth AustraliaAustralia
- Department of Obstetrics and GynaecologyWomen's and Children's HospitalAdelaideSouth AustraliaAustralia
| | - Hiten D. Mistry
- Department of Women and Children's Health, Faculty of Medicine, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Joel Singer
- School of Population and Public HealthUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Sarah R. Crozier
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Applied Research Collaboration Wessex, Southampton Science ParkSouthamptonUK
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Janis Baird
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Applied Research Collaboration Wessex, Southampton Science ParkSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Peter von Dadelszen
- Department of Women and Children's Health, Faculty of Medicine, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Laura A. Magee
- Department of Women and Children's Health, Faculty of Medicine, School of Life Course and Population SciencesKing's College LondonLondonUK
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Xu L, Cheng J, Dong X, Guo M, Chen K, Fan X, Mu X, Wang Y, Xia Z, Li J, Wang Y, Xiong C, Zhou A. Associations of prenatal blood pressure trajectory and variability with child neurodevelopment at 2 years old. BMC Med 2024; 22:220. [PMID: 38816882 PMCID: PMC11140879 DOI: 10.1186/s12916-024-03439-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/23/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND The patterns of blood pressure (BP) change throughout the pregnancy were related to adverse birth outcomes. However, little is known about the long-term effect of BP change patterns on child neurodevelopment. This study aimed to explore the relationship between the BP trajectory and BP variability during pregnancy and early childhood neurodevelopment. METHOD A total of 2797 mother-newborn pairs were derived from the Wuhan Healthy Baby Cohort Study. BP was measured during each antenatal visit, and Mental and Psychomotor Development Indexes (MDI and PDI) were assessed using the Bayley Scales of Infant Development (BSID) when the children were 2 years old. Delayed neurodevelopment was defined as scores of PDI or MDI less than - 1SD relative to the mean score of the study population. A group-based multi-trajectory model was adopted to identify multi-trajectories of systolic blood pressure (SBP) and diastolic blood pressure (DBP). Visit-to-visit BP variability was assessed by the coefficient of variation (CV), standard deviation (SD), and average real variability (ARV). Generalized linear models and multivariate logistic regressions were used to assess the associations of BP trajectories and variability with BSID scores and delayed neurodevelopment, respectively. RESULTS Five distinct trajectories for SBP and DBP were identified, namely, "Low-increasing," "Low-stable," "Moderate-decreasing," "Moderate-increasing," and "High-stable" groups. Compared with the "Low-stable" group, the children whose mothers' BP fell into the other four groups had lower PDI scores, and mothers in the "Low-increasing," "Moderate-increasing," and "Moderate-decreasing" groups had 43% (OR: 1.43, 95% CI: 1.01, 2.03), 48% (OR: 1.48, 95% CI: 1.05, 2.08) and 45% (OR:1.45, 95% CI: 1.03, 2.04) higher risk of having offspring with delayed psychomotor neurodevelopment, respectively. High DBP variability was associated with lower BSID scores, and delayed psychomotor neurodevelopment (OR = 1.46, 95% CI: 1.10, 1.92 for DBP-SD; OR = 1.53, 95% CI: 1.16, 2.02 for DBP-CV). CONCLUSION Our findings suggest that BP change patterns assessed by multi-trajectory and visit-to-visit variability were associated with lower BSID scores and delayed neurodevelopment. Health professionals should be aware of the influence of BP level and its oscillations during pregnancy on the risk of delayed neurodevelopment.
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Affiliation(s)
- Luli Xu
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jiayi Cheng
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaohan Dong
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Menglan Guo
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Kai Chen
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoxuan Fan
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaofeng Mu
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuji Wang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhiguo Xia
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jun Li
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Youjie Wang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Chao Xiong
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Aifen Zhou
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Wilson MG, Bone JN, Mistry HD, Slade LJ, Singer J, von Dadelszen P, Magee LA. Blood Pressure and Heart Rate Variability and the Impact on Pregnancy Outcomes: A Systematic Review. J Am Heart Assoc 2024; 13:e032636. [PMID: 38410988 PMCID: PMC10944029 DOI: 10.1161/jaha.123.032636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/17/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Long-term (visit-to-visit) blood pressure variability (BPV) and heart rate variability (HRV) outside pregnancy are associated with adverse cardiovascular outcomes. Given the limitations of relying solely on blood pressure level to identify pregnancies at risk, long-term (visit-to-visit) BPV or HRV may provide additional diagnostic/prognostic counsel. To address this, we conducted a systematic review to examine the association between long-term BPV and HRV in pregnancy and adverse maternal and perinatal outcomes. METHODS AND RESULTS Databases were searched from inception to May 2023 for studies including pregnant women, with sufficient blood pressure or heart rate measurements to calculate any chosen measure of BPV or HRV. Studies were excluded that reported short-term, not long-term, variability. Adjusted odds ratios were extracted. Eight studies (138 949 pregnancies) reporting BPV met our inclusion criteria; no study reported HRV and its association with pregnancy outcomes. BPV appeared to be higher in women with hypertension and preeclampsia specifically, compared with unselected pregnancy cohorts. Greater BPV was associated with significantly more adverse pregnancy outcomes, particularly maternal (gestational hypertension [odds ratio range, 1.40-2.15], severe hypertension [1.40-2.20]), and fetal growth (small-for-gestational-age infants [1.12-1.32] or low birth weight [1.18-1.39]). These associations were independent of mean blood pressure level. In women with hypertension, there were stronger associations with maternal outcomes but no consistent pattern for perinatal outcomes. CONCLUSIONS Future work should aim to confirm whether BPV could be useful for risk stratification prospectively in pregnancy, and should determine the optimal management path for those women identified at increased risk of adverse outcomes.
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Affiliation(s)
- Milly G. Wilson
- Department of Women and Children’s HealthSchool of Life Course and Population Health Sciences, Faculty of Medicine, King’s College LondonUK
| | - Jeffrey N. Bone
- British Columbia Children’s Hospital Research Institute, University of British ColumbiaVancouverCanada
- Department of Obstetrics and GynaecologyUniversity of British ColumbiaVancouverCanada
| | - Hiten D. Mistry
- Department of Women and Children’s HealthSchool of Life Course and Population Health Sciences, Faculty of Medicine, King’s College LondonUK
| | - Laura J. Slade
- Robinson Research Institute, The University of AdelaideSouth AustraliaAustralia
- Department of Obstetrics and GynaecologyWomen’s and Children’s HospitalAdelaideAustralia
| | - Joel Singer
- School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
| | - Peter von Dadelszen
- Department of Women and Children’s HealthSchool of Life Course and Population Health Sciences, Faculty of Medicine, King’s College LondonUK
| | - Laura A. Magee
- Department of Women and Children’s HealthSchool of Life Course and Population Health Sciences, Faculty of Medicine, King’s College LondonUK
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Left atrial structure and function: association with blood pressure variability in pregnant women. Blood Press Monit 2023; 28:42-46. [PMID: 36606478 DOI: 10.1097/mbp.0000000000000626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The aim of this study was to investigate the relationship between left atrial (LA) abnormalities and ambulatory blood pressure variability (BPV) in pregnant women and their relationship with hypertension-related clinical outcomes in pregnancy. METHODS This single-center, prospective study included 119 pregnant women. All participants underwent 24-h ambulatory blood pressure (BP) monitoring and echocardiographic examination before 20 weeks of gestation. BPV was evaluated using 24-h ambulatory BP monitoring. SD of the mean of SBP (SBP-SD) and DBP variability was calculated as 24-h, daytime and nighttime SBP and DBP. The patients were classified into two groups based on median 24-h SBP-SD (11.3 mmHg). LA features of the patients were compared according to the high and low BPV groups. RESULTS One hundred and nineteen pregnant women (mean age, 28.6 ± 5.2 years) were included in the study. The mean office SBP and DBP were 108.7 ± 15.4 mmHg and 68.2 ± 10.2 mmHg, respectively. In pregnant women with high BPV, even though BP is normal, reservoir and conduit LA functions have decreased and LA stiffness has increased. Gestational hypertension and composite outcomes were more common in pregnant women with high BPV. Among the LA parameters, the most associated with composite outcome was conduit LA function. CONCLUSION In pregnancy, higher BPV is associated with worse LA function. The LA conduit strain offers potential value in predicting hypertension-related clinical outcomes in pregnancy.
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Gu Y, Shi H, Zeng W, Zheng Y, Yang M, Sun M, Shi H, Gu W. Association between gestational visit-to-visit blood pressure variability and adverse neonatal outcomes. J Clin Hypertens (Greenwich) 2022; 24:779-788. [PMID: 35567772 PMCID: PMC9180330 DOI: 10.1111/jch.14500] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 11/28/2022]
Abstract
The authors aimed to explore the association between visit‐to‐visit blood pressure variability (BPV) in pregnant women and adverse neonatal outcomes. The study included 52 891 pregnant women. BPV was calculated as standard deviation (SD) and coefficient of variation (CV) of systolic blood pressure (SBP) or diastolic blood pressure (DBP). All participants were divided into four groups by the quartiles of BPV. When comparing the highest quartiles to the lowest quartiles of DBP SD in all participants, the fully adjusted ORs were 1.19 (95% CI 1.11–1.27, p for trend < .001) for fetal distress, 1.32 (95% CI 1.14–1.54, p for trend < .001) for small for gestational age, 1.32 (95% CI 1.06–1.63, p for trend = .003) for 1‐min Apgar score ≤ 7. When comparing the highest quartiles to the lowest quartiles of DBP CV, ORs were 1.22 (95% CI 1.14–1.30, p for trend < .001) for fetal distress, 1.38 (95% CI 1.17–1.61, p for trend < .001) for small for gestational age, 1.43 (95% CI 1.14–1.79, p for trend < .001) for 1‐min Apgar score ≤ 7. ORs for preterm birth and 5‐min Apgar score ≤ 7 were not statistically significant. However, in participants with gestational hypertension or preeclampsia, ORs for preterm birth were 2.80 (95% CI 1.99–3.94, p for trend < .001) in DBP SD and 3.25 (95% CI 2.24–4.72, p for trend < .001) in DBP CV when extreme quartiles were compared. In conclusion, higher visit‐to‐visit BPV was associated with adverse neonatal outcomes.
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Affiliation(s)
- Yingjie Gu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Haofan Shi
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Weijian Zeng
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Yulong Zheng
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Mengnan Yang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Mengru Sun
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Hong Shi
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Wei Gu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
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Tadic M, Cuspidi C, Suzic Lazic J, Vukomanovic V, Mihajlovic S, Savic P, Cvrkotic M, Grassi G, Celic V. Blood pressure variability correlates with right ventricular strain in women with gestational hypertension and preeclampsia. J Hum Hypertens 2022; 36:826-832. [PMID: 34272473 PMCID: PMC8284030 DOI: 10.1038/s41371-021-00580-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/30/2021] [Accepted: 07/07/2021] [Indexed: 01/22/2023]
Abstract
The aim of this study was to evaluate the short- and long-term blood pressure (BP) variability and right ventricular (RV) remodeling in women with gestational hypertension and preeclampsia, as well as their association. This cross-sectional study included 161 pregnant women (56 normotensive controls, 55 patients with gestational hypertension, and 50 patients with preeclampsia) after 20 weeks of gestation. All women underwent 24-h ambulatory BP monitoring and echocardiographic examination. Our findings showed that 24-h, daytime and nighttime systolic and diastolic BPs, as well as visit-to-visit systolic and diastolic BPs, were significantly higher in women with gestational hypertension and preeclampsia than in control group. Parameters of short- and long-term BP variability gradually increased from controls, throughout women with preeclampsia, to those with gestational hypertension. RV diameter, E/e' and PAP were significantly higher in women with gestational hypertension and preeclampsia than in controls. Global and free wall RV longitudinal strains, as well as corresponding endo- and epicardial strains, gradually reduced from controls to women with preeclampsia. Parameters of short- and long-term BP variability were independently associated with global and free wall RV longitudinal strain. In conclusion, short- and long-term BP variability was higher in women with pregnancy-induced hypertensive disorders. RV diastolic function and mechanics were deteriorated in these women comparing with controls. A significant association between BP variability and RV longitudinal strain underlines the importance of determination of short- and long-term BP variability during pregnancy.
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Affiliation(s)
- Marijana Tadic
- University Clinical Hospital Center "Dr. Dragisa Misovic-Dedinje", Clinic for Internal medicine, Cardiology Department, Belgrade, Serbia.
| | - Cesare Cuspidi
- University of Milan-Bicocca and Istituto, Auxologico Italiano Clinical Research Unit, Meda, Italy
| | - Jelena Suzic Lazic
- grid.449714.bUniversity Clinical Hospital Center “Dr. Dragisa Misovic-Dedinje”, Clinic for Internal medicine, Cardiology Department, Belgrade, Serbia
| | - Vladan Vukomanovic
- grid.449714.bUniversity Clinical Hospital Center “Dr. Dragisa Misovic-Dedinje”, Clinic for Internal medicine, Cardiology Department, Belgrade, Serbia
| | - Sladjana Mihajlovic
- grid.449714.bUniversity Clinical Hospital Center “Dr. Dragisa Misovic-Dedinje”, Clinic for gynecology, Belgrade, Serbia
| | - Predrag Savic
- grid.449714.bUniversity Clinical Hospital Center “Dr. Dragisa Misovic-Dedinje”, Clinic for Internal medicine, Cardiology Department, Belgrade, Serbia
| | - Marko Cvrkotic
- grid.449714.bUniversity Clinical Hospital Center “Dr. Dragisa Misovic-Dedinje”, Clinic for Internal medicine, Cardiology Department, Belgrade, Serbia
| | - Guido Grassi
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | - Vera Celic
- grid.449714.bUniversity Clinical Hospital Center “Dr. Dragisa Misovic-Dedinje”, Clinic for Internal medicine, Cardiology Department, Belgrade, Serbia
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Mogi M, Higashi Y, Bokuda K, Ichihara A, Nagata D, Tanaka A, Node K, Nozato Y, Yamamoto K, Sugimoto K, Shibata H, Hoshide S, Nishizawa H, Kario K. Annual reports on hypertension research 2020. Hypertens Res 2022; 45:15-31. [PMID: 34650193 DOI: 10.1038/s41440-021-00766-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 02/08/2023]
Abstract
In 2020, 199 papers were published in Hypertension Research. Many excellent papers have contributed to progress in research on hypertension. Here, our editorial members have summarized eleven topics from published work and discussed current topics in depth. We hope you enjoy our special feature, Annual Reports on Hypertension Research.
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Affiliation(s)
- Masaki Mogi
- Deparment of Pharmacology, Ehime University Graduate School of Medicine, Tohon, Ehime, Japan.
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Hiroshima, Japan.,Divivsion of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Kanako Bokuda
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Atsuhiro Ichihara
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Daisuke Nagata
- Division of Nephrology, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga, Saga, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Saga, Japan
| | - Yoichi Nozato
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Koichi Yamamoto
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Ken Sugimoto
- General and Geriatric Medicine, Kawasaki Medical University, Okayama, Okayama, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Hitoshi Nishizawa
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
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8
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Tadic M, Cuspidi C, Suzic-Lazic J, Vukomanovic V, Mihajlovic S, Savic P, Blagojevic N, Grassi G, Celic V. Blood-pressure variability is associated with left-ventricular mechanics in patients with gestational hypertension and preeclampsia. Hypertens Res 2021; 44:1625-1632. [PMID: 34599294 DOI: 10.1038/s41440-021-00768-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 08/07/2021] [Accepted: 08/29/2021] [Indexed: 01/22/2023]
Abstract
We aimed to investigate short- and long-term blood-pressure (BP) variability and left-ventricular (LV) structure, function, and mechanics in women with gestational hypertension and preeclampsia, as well as the relationship between BP variability and LV mechanics. This cross-sectional study included 140 pregnant women (45 normotensive controls, 50 patients with gestational hypertension and, 45 patients with preeclampsia) after 20 weeks of gestation. All participants underwent 24-h ambulatory BP monitoring and echocardiographic examination, as well as regular clinical BP measurements during each visit. Our results show that 24-h, daytime and nighttime systolic and diastolic BP, as well as visit-to-visit systolic and diastolic BPs, gradually increased from controls across patients with preeclampsia to those with gestational hypertension. Similar changes were observed for 24-h systolic BP-variability indices. LV longitudinal and circumferential strains gradually decreased from controls across women with gestational hypertension to patients with preeclampsia. Radial strain was significantly lower in women with preeclampsia than in controls. Indices of short- and long-term BP variability were independent of BP and demographic and echocardiographic parameters associated with LV longitudinal and circumferential strain. In conclusion, LV mechanics are impaired in women with gestational hypertension and preeclampsia compared with LV mechanics in normotensive controls. Short- and long-term BP variability was higher in patients with hypertensive disorders and was significantly associated with longitudinal and circumferential strains.
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Affiliation(s)
- Marijana Tadic
- University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Clinic for Internal Medicine, Cardiology Department, Heroja Milana Tepica 1, 11000, Belgrade, Serbia.
| | - Cesare Cuspidi
- University of Milan-Bicocca and Istituto Auxologico Italiano, Clinical Research Unit Viale della Resistenza 23, 20036, Meda, Italy
| | - Jelena Suzic-Lazic
- University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Clinic for Internal Medicine, Cardiology Department, Heroja Milana Tepica 1, 11000, Belgrade, Serbia
| | - Vladan Vukomanovic
- University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Clinic for Internal Medicine, Cardiology Department, Heroja Milana Tepica 1, 11000, Belgrade, Serbia
| | - Sladjana Mihajlovic
- University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Clinic for Gynecology, Heroja Milana Tepica 1, 11000, Belgrade, Serbia
| | - Predrag Savic
- University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Clinic for Internal Medicine, Cardiology Department, Heroja Milana Tepica 1, 11000, Belgrade, Serbia
| | - Nikola Blagojevic
- University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Clinic for Internal Medicine, Cardiology Department, Heroja Milana Tepica 1, 11000, Belgrade, Serbia
| | - Guido Grassi
- Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | - Vera Celic
- University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Clinic for Internal Medicine, Cardiology Department, Heroja Milana Tepica 1, 11000, Belgrade, Serbia
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