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Espeche WG, Salazar MR, Minetto J, Cerri G, Carrera Ramos P, Soria A, Santillan C, Grassi F, Torres S, Carbajal HA. Relationship between serum uric acid, nocturnal hypertension and risk for preeclampsia in high-risk pregnancies. J Hum Hypertens 2024; 38:642-648. [PMID: 39043990 DOI: 10.1038/s41371-024-00939-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/10/2024] [Accepted: 07/17/2024] [Indexed: 07/25/2024]
Abstract
To analyze the possible association between serum uric acid (SUA) and nocturnal hypertension and to evaluate the ability of these variables (alone or in combination) to predict preeclampsia (PE) we conducted a historical cohort study in 532 high-risk pregnancies. Women were divided according to SUA values and nocturnal blood pressure (BP) into four groups: 1- normal SUA and nocturnal normotension; 2- high SUA and nocturnal normotension; 3- normal SUA and nocturnal hypertension and 4- high SUA and nocturnal hypertension. High SUA was defined by the top quartile values and nocturnal hypertension as BP ≥ 120/70 mmHg, using ambulatory blood pressure monitoring (ABPM), during nocturnal rest. Risks for PE were compared using logistic regression. SUA had a weak but significant correlation with daytime systolic ABPM (r = 0.11, p = 0.014), daytime diastolic ABPM (r = 0.13, p = 0.004), nighttime systolic ABPM (r = 0.16, p < 0.001) and nighttime diastolic ABPM (r = 0.18, p < 0.001). Also, all ABPM values were higher in women with high SUA. The absolute risk of PE increased through groups: 6.5%, 13.1%, 31.2%, and 47.9% for groups 1, 2, 3, and 4, respectively, p < 0.001. Compared with Group 1, Group 3 (OR 6.29 95%CI 3.41-11.60), but not Group 2 (OR 2.15 95%CI 0.88-5.24), had statistically significant higher risk for PE. Group 4 (women with both, high SUA and nocturnal hypertension) had the highest risk (OR 13.11 95%CI 6.69-25.70). Risks remained statistically significant after the adjustment for relevant variables. In conclusion, the combination of SUA > 4 mg/dL and nocturnal BP > 120/70 mmHg implies a very high risk to developed PE.
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Affiliation(s)
- Walter G Espeche
- Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín, La Plata, Argentina
- Facultad de Ciencias Médicas, UNLP, La Plata, Argentina
| | - Martin R Salazar
- Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín, La Plata, Argentina.
- Facultad de Ciencias Médicas, UNLP, La Plata, Argentina.
| | - Julián Minetto
- Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín, La Plata, Argentina
- Facultad de Ciencias Médicas, UNLP, La Plata, Argentina
| | - Gustavo Cerri
- Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín, La Plata, Argentina
| | - Patricia Carrera Ramos
- Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín, La Plata, Argentina
| | - Adelaida Soria
- Servicio de Obstetricia, Hospital Gral. San Martín, La Plata, Argentina
| | - Claudia Santillan
- Servicio de Obstetricia, Hospital Gral. San Martín, La Plata, Argentina
| | - Florencia Grassi
- Servicio de Obstetricia, Hospital Gral. San Martín, La Plata, Argentina
| | - Soledad Torres
- Servicio de Obstetricia, Hospital Gral. San Martín, La Plata, Argentina
| | - Horacio A Carbajal
- Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín, La Plata, Argentina
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Chen Y, Pan X, Xiang G, Liu H. More need to optimize the prediction model of sFlt- 1/PIGF ratio and ambulatory blood pressure monitoring in preeclampsia. Hypertens Res 2024; 47:1438-1439. [PMID: 38383892 DOI: 10.1038/s41440-024-01620-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/18/2024] [Accepted: 01/27/2024] [Indexed: 02/23/2024]
Affiliation(s)
- Yunshan Chen
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiuyu Pan
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Guochun Xiang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Huishu Liu
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
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Espeche W, Minetto J, Salazar MR. Utility of 24-hour ambulatory monitoring and the Sflt-1/PlGF ratio in preeclampsia prediction. Hypertens Res 2024; 47:1436-1437. [PMID: 38383891 DOI: 10.1038/s41440-024-01600-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/13/2024] [Indexed: 02/23/2024]
Affiliation(s)
- Walter Espeche
- Faculty of Medical Sciences, National University of La Plata, La Plata, Argentina
- San Martin General Acute Care Interzonal Hospital, La Plata, Argentina
| | - Julian Minetto
- Faculty of Medical Sciences, National University of La Plata, La Plata, Argentina.
- San Martin General Acute Care Interzonal Hospital, La Plata, Argentina.
| | - Martin R Salazar
- Faculty of Medical Sciences, National University of La Plata, La Plata, Argentina
- San Martin General Acute Care Interzonal Hospital, La Plata, Argentina
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Salazar MR. Placental hypoxia, high nighttime blood pressure, and maternal health. Hypertens Res 2024; 47:972-974. [PMID: 38182907 DOI: 10.1038/s41440-023-01567-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024]
Affiliation(s)
- Martin R Salazar
- Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Provincia de Buenos Aires, Argentina.
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