1
|
Imai Y. A personal history of research on hypertension From an encounter with hypertension to the development of hypertension practice based on out-of-clinic blood pressure measurements. Hypertens Res 2022; 45:1726-1742. [PMID: 36075990 DOI: 10.1038/s41440-022-01011-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/09/2022]
Abstract
In the 1970s, many people had severe hypertension and related cardiovascular and cerebrovascular diseases; however, antihypertensive treatments were not available at the time. The author encountered such conditions during the initial exposure to medicine. The author subsequently entered the field of hypertension medicine to prevent such conditions and engaged in hypertension research for more than 50 years. The author's central interest was the physiological and clinical aspects of blood pressure (BP) variability. Out-of-clinic BP measurements were the focus of clinical research. It was anticipated that self-measurement of BP at home (HBP) would improve medical practice surrounding hypertension. To establish evidence-based hypertension medicine, the Ohasama study (an epidemiology based on HBP) was conducted. The study provided firm evidence of the clinical significance of HBP and diagnostic criteria for hypertension and normotension. To establish target HBP levels for antihypertensive therapy, the Hypertension Objective treatment based on Measurement by Electrical Devices of Blood Pressure (HOMED-BP) study (a prospective intervention study) was also conducted. Application of HBP measurements expanded to obstetric, clinical pharmacology, pathophysiology, and genetic studies. During these studies, crucial information on the clinical significance of BP variability (such as circadian and day-by-day variation of BP, nocturnal BP, white-coat hypertension, and masked hypertension) was established. Finally, the author described the priority of HBP over clinic-measured BP for the diagnosis of hypertension in the 2014 Japanese Society of Hypertension Guidelines. In this article, the author's history of hypertension research, from the first encounter with hypertension to the construction of guidelines on hypertension, is reviewed.
Collapse
Affiliation(s)
- Yutaka Imai
- Tohoku Institute for the Management of Blood Pressure, Sendai, Japan. .,Emeritus Professor Tohoku University, Sendai, Japan.
| |
Collapse
|
2
|
Hypertensive disorders of pregnancy: definition, management, and out-of-office blood pressure measurement. Hypertens Res 2022; 45:1298-1309. [PMID: 35726086 PMCID: PMC9207424 DOI: 10.1038/s41440-022-00965-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/11/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022]
Abstract
Hypertensive disorders of pregnancy increase the risk of adverse maternal and fetal outcomes. In 2018, the Japanese classification of hypertensive disorders of pregnancy was standardized with those of other countries, and a hypertensive disorder of pregnancy was considered to be present if hypertension existed during pregnancy and up to 12 weeks after delivery. Strategies for the prevention of hypertensive disorders of pregnancy have become much clearer, but further research is needed on appropriate subjects and methods of administration, and these have not been clarified in Japan. Although guidelines for the use of antihypertensive drugs are also being studied and standardized with those of other countries, the use of calcium antagonists before 20 weeks of gestation is still contraindicated in Japan because of the safety concerns that were raised regarding possible fetal anomalies associated with their use at the time of their market launch. Chronic hypertension is now included in the definition of hypertensive disorders of pregnancy, and blood pressure measurement is a fundamental component of the diagnosis of hypertensive disorders of pregnancy. Out-of-office blood pressure measurements, including ambulatory and home blood pressure measurements, are important for pregnant and nonpregnant women. Although conditions such as white-coat hypertension and masked hypertension have been reported, determining their occurrence in pregnancy is complicated by the gestational week. This narrative review focused on recent reports on hypertensive disorders of pregnancy, including those related to blood pressure measurement and classification. ![]()
Collapse
|
3
|
Kobayashi S, Sata F, Kishi R. Gene-environment interactions related to maternal exposure to environmental and lifestyle-related chemicals during pregnancy and the resulting adverse fetal growth: a review. Environ Health Prev Med 2022; 27:24. [PMID: 35675978 PMCID: PMC9251623 DOI: 10.1265/ehpm.21-00033] [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] [Indexed: 11/09/2022] Open
Abstract
Background There are only limited numbers of reviews on the association of maternal-child genetic polymorphisms and environmental and lifestyle-related chemical exposure during pregnancy with adverse fetal growth. Thus, this article aims to review: (1) the effect of associations between the above highlighted factors on adverse fetal growth and (2) recent birth cohort studies regarding environmental health risks. Methods Based on a search of the PubMed database through August 2021, 68 epidemiological studies on gene-environment interactions, focusing on the association between environmental and lifestyle-related chemical exposure and adverse fetal growth was identified. Moreover, we also reviewed recent worldwide birth cohort studies regarding environmental health risks. Results Thirty studies examined gene-smoking associations with adverse fetal growth. Sixteen maternal genes significantly modified the association between maternal smoking and adverse fetal growth. Two genes significantly related with this association were detected in infants. Moreover, the maternal genes that significantly interacted with maternal smoking during pregnancy were cytochrome P450 1A1 (CYP1A1), X-ray repair cross-complementing protein 3 (XRCC3), interleukin 6 (IL6), interleukin 1 beta (IL1B), human leukocyte antigen (HLA) DQ alpha 1 (HLA-DQA1), HLA DQ beta 1 (HLA-DQB1), and nicotinic acetylcholine receptor. Fetal genes that had significant interactions with maternal smoking during pregnancy were glutathione S-transferase theta 1 (GSTT1) and fat mass and obesity-associated protein (FTO). Thirty-eight studies examined the association between chemical exposures and adverse fetal growth. In 62 of the 68 epidemiological studies (91.2%), a significant association was found with adverse fetal growth. Across the studies, there was a wide variation in the analytical methods used, especially with respect to the genetic polymorphisms of interest, environmental and lifestyle-related chemicals examined, and the study design used to estimate the gene-environment interactions. It was also found that a consistently increasing number of European and worldwide large-scale birth cohort studies on environmental health risks have been conducted since approximately 1996. Conclusion There is some evidence to suggest the importance of gene-environment interactions on adverse fetal growth. The current knowledge on gene-environment interactions will help guide future studies on the combined effects of maternal-child genetic polymorphisms and exposure to environmental and lifestyle-related chemicals during pregnancy. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.21-00033.
Collapse
Affiliation(s)
| | - Fumihiro Sata
- Center for Environmental and Health Sciences, Hokkaido University.,Health Center, Chuo University
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University
| |
Collapse
|
4
|
Khodadadi N, Dastoorpoor M, Khanjani N, Ghasemi A. Universal Thermal Climate Index (UTCI) and adverse pregnancy outcomes in Ahvaz, Iran. Reprod Health 2022; 19:33. [PMID: 35109854 PMCID: PMC8811963 DOI: 10.1186/s12978-022-01344-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/03/2022] [Indexed: 12/19/2022] Open
Abstract
Background Climate change may jeopardize the health of mothers and their offspring. There are few studies on the association between increasing temperature and pregnancy outcomes. The aim of this study was to investigate the relation between Universal Thermal Climate Index (UTCI) and adverse pregnancy outcomes including stillbirth, low birth weight (LBW), preterm labor (PTL), spontaneous abortion (SA), preeclampsia and hypertension in Ahvaz, Iran. Methods Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to research the effect of UTCI on adverse pregnancy outcomes. The effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted. Results The results showed that the low values of UTCI index (11.6 °C, in lags 0–6, 0–13) caused significant increase in the risk of preterm labor. However, hot thermal stress (high UTCI) significantly increased the risk of stillbirth in lag 0–13. We did not observe any significant relation between UTCI and other pregnancy outcomes in this study. Conclusions It seems like both hot and cold weathers can be associated with adverse pregnancy outcomes. Scientists have found that climate change has adverse effects on human health. Because pregnant women are one of the most vulnerable groups, these negative impacts may affect their fetuses, which make up the next generation. In this study, we examined the effect of temperature on some pregnancy outcomes, including low birth weight, preterm labor, spontaneous abortion, preeclampsia and gestational hypertension in Ahvaz city, which is one of the hottest cities in the world. One way to assess temperature impact on humans is by using temperature indicators. In this study we used the Universal Thermal Climate Index (UTCI) for this purpose. The data at different time intervals were collected and evaluated with specific models. Our results showed that low values of UTCI, which is equivalent to cold weather, significantly increase the risk of preterm labor. But, high levels of UTCI, which means hot weather, significantly increase the risk of stillbirth. In conclusion; both hot and cold weather can be associated with adverse pregnancy outcomes in Ahvaz city. Therefore, pregnant women should protect themselves from exposure to hot and cold weather.
Collapse
Affiliation(s)
- Narges Khodadadi
- Department of Epidemiology and Biostatistics, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Dastoorpoor
- Department of Epidemiology and Biostatistics, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Afsaneh Ghasemi
- Department of Public Health, School of Public Health, Fasa University of Medical Sciences, Fasa, Iran.
| |
Collapse
|
5
|
Singh DK, Sinha N, Bera OP, Saleem SM, Tripathi S, Shikha D, Goyal M, Bhattacharya S. Effects of diet on hypertensive disorders during pregnancy: A cross-sectional study from a teaching hospital. J Family Med Prim Care 2021; 10:3268-3272. [PMID: 34760742 PMCID: PMC8565134 DOI: 10.4103/jfmpc.jfmpc_96_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/12/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Pregnancy is a positive, fulfilling experience for many, but it can put the mother at the risk of suffering ill-health, disability, or even maternal death. The common causes of maternal death include pregnancy-induced hypertension (PIH) or gestational hypertension or hypertensive disorders in pregnancy (HDP), post-partum hemorrhage, and pulmonary embolism. Modifications in lifestyle and diet have been widely advocated as a cost-effective strategy to prevent PIH. Objectives: To assess the role of dietary factors in PIH attending antenatal care services at a teaching hospital. Materials and Methods: Pregnant women who were attending the antenatal clinic who were diagnosed with hypertension in pregnancy and normotensive before the pregnancy were included in the study. As per the protocol, informed written consent, demographic details with clinical data were obtained from the patients. A total of 225 antenatal cases having hypertension in pregnancy were included in our study. Results: Majority of the study subjects (81.8%) were taking mixed diets, 50.2% consumed additional salt in their diet, the intake history of visible fat was given by 25.3% and 96.4% consumed tea while 52.9% had a history of consuming junk food. Among the 41 vegetarian study subjects with hypertension in pregnancy, the maximum subjects (73.1%) had preeclampsia followed by gestational hypertension in 23.6% the subjects. The relation between the type of diet and hypertension in pregnancy was found to be statistically insignificant. The relation between visible fat consumption and hypertension in pregnancy was found to be statistically significant. Discussion: The association of dietary factors with HDP could be explained by several factors. One being the high-calorie intake by women with known HDP and those without HDP. The imbalance between the energy intake and expenditure is a potential risk factor and leads to overweight or obesity. Conclusion: The consumption of additional salt in the diet, visible fat, and obesity was found to be associated with HDP in our study.
Collapse
Affiliation(s)
- Dhananjay Kumar Singh
- Department of Community Medicine, Rajarshi Dashrath Autonomous State Medical College, Ayodhya, Uttar Pradesh, India
| | - Nikhil Sinha
- Department of General Medicine, Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
| | - Om Prakash Bera
- Principal Consultant, Global Health Advocacy Incubator, Jammu & Kashmir, India
| | | | - Shailesh Tripathi
- Visiting Consultant, Lucknow University, Lucknow, Uttar Pradesh, India
| | - Deep Shikha
- Department of Community Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Manish Goyal
- Department of Statistics, Post Graduate Government College, Chandigarh, India
| | | |
Collapse
|
6
|
Obara T. [Study on the Safety of Perinatal Medication]. YAKUGAKU ZASSHI 2021; 141:463-471. [PMID: 33790112 DOI: 10.1248/yakushi.20-00184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We have been conducting research with the aim of generating evidence for the safety of perinatal drugs. As a result of reviewing the records of inquiries to the Drug Information Office of our hospital, we found a large discrepancy between the description of perinatal drugs in package inserts in Japan and the description of the Pregnancy Risk Category according to the U.S. Food and Drug Administration. In the Japan Environment and Children's Study (JECS), we determined the proportion of drug and supplement use among 97464 pregnant women. We clarified that prescriptions of antihypertensive drugs for pregnant women increased during the second half of pregnancy, while prescriptions of anti-epileptic and anti-anxiety drugs decreased after pregnancy using a claims database. A survey of pharmacists and pharmacy students revealed a lack of awareness of effective folic acid intake to reduce the risk of neural tube defects in infants. The percentage of pre-pregnancy folic acid supplementation among pregnant women participating in the Babies and their Parents' Longitudinal Observation in Suzuki Memorial Hospital on Intrauterine Period (BOSHI) study, the JECS, and the Tohoku Medical Megabank (TMM) Birth and Three-Generation (BirThree) cohort study was 6.3-18.0%. As a result of close examination of the records of inquiries to the Drug Information Office of our hospital, and of cases in which our lactation plan sheet was applied, it was found that there were discrepancies between the information on the drug package insert and the information on Medications & Mother's Milk, etc. in Japan. The results obtained have been clinically applied in daily practice and we are continuing our research while taking measures.
Collapse
Affiliation(s)
- Taku Obara
- Department of Pharmaceutical Sciences, Tohoku University.,Department of Molecular Epidemiology, Tohoku University Graduate School of Medicine.,Division of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization
| |
Collapse
|
7
|
Dastoorpoor M, Khanjani N, Khodadadi N. Association between Physiological Equivalent Temperature (PET) with adverse pregnancy outcomes in Ahvaz, southwest of Iran. BMC Pregnancy Childbirth 2021; 21:415. [PMID: 34088277 PMCID: PMC8178880 DOI: 10.1186/s12884-021-03876-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 05/13/2021] [Indexed: 12/16/2022] Open
Abstract
Background There are few epidemiological studies on the relation between temperature changes and adverse pregnancy outcomes. The purpose of this study was to determine the relation between Physiological Equivalent Temperature (PET) with adverse pregnancy outcomes including stillbirth, low birth weight (LBW), preterm labor (PTL), spontaneous abortion (SA), preeclampsia and hypertension in Ahvaz, Iran. Methods Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to investigate the effect of PET on adverse pregnancy outcomes. In this study the effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted. Results High PET (45.4 C°, lag = 0) caused a significant increase in risk of stillbirth. Also, high levels of PET (45.4, 43.6, 42.5 C°, lag = 0–6) and low levels of PET (9.9, 16.9 C°, lags = 0, 0–13, 0–21) significantly increased the risk of LBW. But, low levels of PET (6.4, 9.9, 16.9 C°, lags = 0–6, 0–13) reduced the risk of gestational hypertension. Conclusion The results of this study showed that hot and cold thermal stress may be associated with increased risk of stillbirth, and LBW in Ahvaz.
Collapse
Affiliation(s)
- Maryam Dastoorpoor
- Department of Epidemiology and Biostatistics, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Narges Khodadadi
- Department of Epidemiology and Biostatistics, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| |
Collapse
|
8
|
Suzuki H, Takagi K, Tanaka K, Ichihara A, Seki H. A survey on the measurement of blood pressure in pregnant women and management of hypertensive disorders of pregnancy by the Japan Society for the Study of Hypertension in Pregnancy (JSSHP). HYPERTENSION RESEARCH IN PREGNANCY 2021. [DOI: 10.14390/jsshp.hrp2020-013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Hirotada Suzuki
- Departments of Obstetrics and Gynecology, Jichi Medical University School of Medicine
| | - Kenjiro Takagi
- Perinatal Center, Division of Maternal and Fetal Medicine, Jichi Medical University, Saitama Medical Center
| | - Kanji Tanaka
- Perinatal Medical Center, Hirosaki University Hospital
| | - Atsuhiro Ichihara
- Department of Endocrinology and Hypertension, Tokyo Women’s Medical University
| | - Hiroyuki Seki
- Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University
| | | |
Collapse
|
9
|
Nakanishi M, Mizuno T, Mizokami F, Koseki T, Takahashi K, Tsuboi N, Katz M, Lee JK, Yamada S. Impact of pharmacist intervention for blood pressure control in patients with chronic kidney disease: A meta-analysis of randomized clinical trials. J Clin Pharm Ther 2020; 46:114-120. [PMID: 32949161 DOI: 10.1111/jcpt.13262] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 12/15/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Hypertension (HTN) and chronic kidney disease (CKD) are recognized as silent killers because they are asymptomatic conditions that contribute to the burden of multiple comorbidities. The achievement of a blood pressure (BP) goal can dramatically reduce the risks of CKD. In this study, we aimed to assess the effectiveness of pharmacist intervention on BP control in patients with CKD and evaluate the usefulness of home-based BP telemonitoring. METHODS The terms "chronic kidney disease," "pharmacist," "BP" and "randomized controlled trial (RCT)" were used five databases to search for information regarding pharmacist intervention on BP control in patients with CKD. The inclusion criteria were as follows: (a) studies for adult patients with uncontrolled HTN and (b) studies with adequate data for meta-analysis. The primary outcome was an evaluation of achievement of BP goal in patients with CKD. The secondary outcome was usefulness of home-based BP telemonitoring by pharmacists in patients with CKD. RESULTS AND DISCUSSION Six RCTs were identified and included in the meta-analysis with a total of 2573 patients (mean age 66.0 years and 63.9% male). Pharmacist interventions resulted in significantly better BP control vs usual care (OR = 1.53, 95% CI = 1.15-2.04, P < .01). Pharmacist interventions using home-based BP telemonitoring were significantly superior to control/usual care (OR = 2.03, 95% CI = 1.49-2.77, P < .01), whereas pharmacist interventions without home-based BP telemonitoring did not significantly improve BP control compared to that with control/usual care (OR = 1.30, 95% CI = 0.97-1.75, P = .08). Home-based BP telemonitoring supported team-based care for HTN in these studies. In addition, patient self-monitoring with telemedicine devices might enhance patients' abilities to manage their condition by pharmacist instruction. WHAT IS NEW AND CONCLUSION The findings of this meta-analysis showed that pharmacist interventions with home-based BP telemonitoring improve BP control among adult patients with CKD.
Collapse
Affiliation(s)
- Masanori Nakanishi
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan.,Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tomohiro Mizuno
- Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Japan
| | - Fumihiro Mizokami
- Department of Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takenao Koseki
- Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuo Takahashi
- Department of Biomedical Molecular Sciences, Fujita Health University School of Medicine, Toyoake, Japan
| | - Naotake Tsuboi
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Michael Katz
- Department of Pharmacy Practice & Science, University of Arizona College of Pharmacy, Tucson, AZ, USA
| | - Jeannie K Lee
- Department of Pharmacy Practice & Science, University of Arizona College of Pharmacy, Tucson, AZ, USA
| | - Shigeki Yamada
- Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Japan
| |
Collapse
|
10
|
Iwama N, Ishikuro M, Tanaka K, Satoh M, Murakami T, Metoki H. Epidemiological studies regarding hypertensive disorders of pregnancy: A review. J Obstet Gynaecol Res 2020; 46:1672-1677. [PMID: 32715567 DOI: 10.1111/jog.14383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/12/2020] [Indexed: 11/30/2022]
Abstract
A hypertensive disorder of pregnancy (HDP) is defined as hypertension emerging after 20 weeks of gestation and resolving up to 12 weeks post-partum, and occurs in about 5% of all pregnancies. Complications associated with HDP have poor prognoses, and maternal deaths attributable to HDP are predicted to exceed 70 000 per year worldwide. Understanding the pathogenesis and risk factors of hypertensive disorders of pregnancy is important, and they are often investigated in observational studies. Given that therapeutic interventions cannot be controlled in observed studies, it is necessary to interpret which factors correspond to exposure and which factors correspond to confounding and intermediate factors in each study. From the Babies and their parents' longitudinal observation in the Suzuki Memorial Hospital on Intrauterine period study, blood pressure in early pregnancy was not only predictive of a child's birthweight, but the trajectory was also associated with the birthweight. From the larger-scale birth cohort studies currently conducted in Japan will provide the novel potential risk factors of hypertensive disorders of pregnancy and preventive strategies of them. In Japan, observational or intervention studies are just beginning to emerge. The continuation of both a distinctive cohort and a large cohort is needed, and the development of good quality intervention trials based on the results of observational studies is important.
Collapse
Affiliation(s)
- Noriyuki Iwama
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Department of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kosuke Tanaka
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan
| | - Michihiro Satoh
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Division of Public health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Japan
| | - Takahisa Murakami
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Division of Public health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Division of Public health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Japan
| |
Collapse
|
11
|
Examining the trimester-specific effects of low gestational weight gain on birthweight: the BOSHI study. J Dev Orig Health Dis 2020; 12:280-285. [PMID: 32319361 DOI: 10.1017/s2040174420000240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Low gestational weight gain (GWG) is a known risk factor of low birthweight. Although studies have previously examined the associations between GWG and birthweight, the period-specific effects of low GWG in each trimester remain unclear. This study aimed to quantify the trimester-specific direct effects of low GWG in Japanese women on birthweight. Using perinatal data from a cohort study, we analyzed pregnant women delivered at an obstetrics/gynecology hospital between October 2006 and May 2010. We focused on women with a pre-pregnancy body mass index (BMI) below 25 kg/m2. The exposure was low GWG. The gestation period was subdivided into trimesters, and the direct effects of low trimester-specific GWG on birthweight were estimated using marginal structural models. These models were guided by a direct acyclic graph that incorporated potential confounders, including pre-pregnancy BMI, age, smoking during pregnancy, height, and parity. We analyzed 563 women and their families. The mean cumulative GWG by the end of the first, second, and third trimesters was 0.9, 6.2, and 10.7 kg, respectively. Approximately 14.0% of the women gained total weight below the range recommended by Japanese Ministry of Health, Labour and Welfare. The direct effects of low GWG on birthweight were 65.9 g (95% confidence interval: 11.4, 120.5), -195.4 g (-263.4, -127.4), and -188.8 g (-292.0, -85.5) for the first, second, and third trimesters, respectively. Insufficient weight gain in the second and third trimesters had a negative impact on birthweight after adjusting for pre-pregnancy BMI and other covariates.
Collapse
|
12
|
Association of maternal home blood pressure trajectory during pregnancy with infant birth weight: the BOSHI study. Hypertens Res 2020; 43:550-559. [DOI: 10.1038/s41440-020-0416-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 12/19/2019] [Accepted: 01/07/2020] [Indexed: 01/01/2023]
|
13
|
Yang R, Luo D, Zhang YM, Hu K, Qian ZM, Hu LQ, Shen LJ, Xian H, Iwelunmor J, Mei SR. Adverse Effects of Exposure to Fine Particulate Matters and Ozone on Gestational Hypertension. Curr Med Sci 2019; 39:1019-1028. [PMID: 31845236 DOI: 10.1007/s11596-019-2137-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 09/25/2019] [Indexed: 11/30/2022]
Abstract
Gestational hypertension (GH) is a common complication during pregnancy. GH is regarded as a potential public health challenge for pregnant women and infants. Limited evidence has linked ambient air pollution to an increased GH risk. However, most of the studies were conducted in developed countries, with inconsistent results obtained. The present study was performed to explore whether exposure to particulate matters with an aerodynamic diameter < 2.5 (PM2.5) and ozone (O3) was related to elevated odds of GH in a Chinese population. This population-based cohort study involved 38 115 pregnant women in Wuhan, China. All information was collected from the Wuhan Maternal and Child Health Management Information System, using standardized quality control. The daily air pollutant data for PM2.5 and O3 were obtained from the 20 monitoring stations of the Wuhan Environmental Monitoring Center during 2014. The nearest monitor approach was applied to individual exposure assessment of PM2.5 and O3 for each participant. After adjusting for major confounders and other air pollutants, a 10 µg/m3 increase in PM2.5 and O3 concentrations was found to correlate to a 1.14-fold [95% confidence interval (95% CI): 1.09, 1.20] and a 1.05-fold (95% CI: 1.02, 1.07) increase in GH risk, respectively. Additionally, stronger relationships between GH risk and PM2.5 and O3 exposure were observed in women who conceived in winter and summer, respectively. These findings suggest that air pollutants may contribute to the development of GH.
Collapse
Affiliation(s)
- Rong Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430015, China.
| | - Dan Luo
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yi-Ming Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430015, China
| | - Ke Hu
- Wuhan Environmental Monitoring Center, Wuhan, 430015, China
| | - Zheng-Min Qian
- College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Li-Qin Hu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Long-Jiao Shen
- Wuhan Environmental Monitoring Center, Wuhan, 430015, China
| | - Hong Xian
- College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Juliet Iwelunmor
- College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Su-Rong Mei
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| |
Collapse
|
14
|
Ohkuchi A, Hirashima C, Arai R, Takahashi K, Suzuki H, Ogoyama M, Nagayama S, Takahashi H, Baba Y, Usui R, Shirasuna K, Matsubara S. Temporary hypertension and white coat hypertension in the first trimester as risk factors for preeclampsia. Hypertens Res 2019; 42:2002-2012. [DOI: 10.1038/s41440-019-0307-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 06/24/2019] [Accepted: 07/18/2019] [Indexed: 11/09/2022]
|
15
|
Okada K, Saito I, Katada C, Tsujino T. Influence of quality of sleep in the first trimester on blood pressure in the third trimester in primipara women. Blood Press 2019; 28:345-355. [PMID: 31266373 DOI: 10.1080/08037051.2019.1637246] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: The purpose of this study was to clarify the relationship between decreased sleep quality during the first trimester and a rise in blood pressure during an otherwise normal course of pregnancy in primipara women. Materials and methods: We recruited 128 pregnant women (primipara) who visited the obstetrics and gynecology clinic for medical examination, of which 89 were longitudinally investigated from the first to the third trimester after obtaining informed consent. A survey was conducted in the first, second, and third trimesters to evaluate sleep quality using the Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J). Patients were assigned to either a good sleep quality group (PSQI-J ≤ 5) or a poor sleep quality group (PSQI-J ≥ 6). Blood pressure was measured using a home blood pressure measurement method. We analyzed the relationship between sleep quality in the first trimester and blood pressure during pregnancy. Results: The increase in morning systolic blood pressure from first to third trimester was larger in the poor sleep quality group than in the good sleep quality group (7.1 ± 7.0 vs. 3.0 ± 5.6 mmHg, p < .01). Sleep latency (r = 0.38, β = 0.43, p = .02) and sleep disturbances (r = 0.24, β = 0.33, p = .04) in the first trimester affected the increase in systolic blood pressure during pregnancy. Conclusions: Understanding sleep quality at the beginning of pregnancy can help predict a rise in systolic blood pressure in the third trimester. This emphasizes the importance of sleep education during pregnancy.
Collapse
Affiliation(s)
- Kimie Okada
- Graduate School of Health Sciences, Kobe University , Kobe , Japan.,Department of Nursing, School of Nursing, Hyogo University of Health Sciences , Kobe , Japan
| | - Izumi Saito
- Graduate School of Health Sciences, Kobe University , Kobe , Japan
| | - Chihiro Katada
- Department of Nursing, School of Nursing, Hyogo University of Health Sciences , Kobe , Japan
| | - Takeshi Tsujino
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences , Kobe , Japan
| |
Collapse
|
16
|
Sugawara J, Ochi D, Yamashita R, Yamauchi T, Saigusa D, Wagata M, Obara T, Ishikuro M, Tsunemoto Y, Harada Y, Shibata T, Mimori T, Kawashima J, Katsuoka F, Igarashi-Takai T, Ogishima S, Metoki H, Hashizume H, Fuse N, Minegishi N, Koshiba S, Tanabe O, Kuriyama S, Kinoshita K, Kure S, Yaegashi N, Yamamoto M, Hiyama S, Nagasaki M. Maternity Log study: a longitudinal lifelog monitoring and multiomics analysis for the early prediction of complicated pregnancy. BMJ Open 2019; 9:e025939. [PMID: 30782942 PMCID: PMC6398744 DOI: 10.1136/bmjopen-2018-025939] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE A prospective cohort study for pregnant women, the Maternity Log study, was designed to construct a time-course high-resolution reference catalogue of bioinformatic data in pregnancy and explore the associations between genomic and environmental factors and the onset of pregnancy complications, such as hypertensive disorders of pregnancy, gestational diabetes mellitus and preterm labour, using continuous lifestyle monitoring combined with multiomics data on the genome, transcriptome, proteome, metabolome and microbiome. PARTICIPANTS Pregnant women were recruited at the timing of first routine antenatal visits at Tohoku University Hospital, Sendai, Japan, between September 2015 and November 2016. Of the eligible women who were invited, 65.4% agreed to participate, and a total of 302 women were enrolled. The inclusion criteria were age ≥20 years and the ability to access the internet using a smartphone in the Japanese language. FINDINGS TO DATE Study participants uploaded daily general health information including quality of sleep, condition of bowel movements and the presence of nausea, pain and uterine contractions. Participants also collected physiological data, such as body weight, blood pressure, heart rate and body temperature, using multiple home healthcare devices. The mean upload rate for each lifelog item was ranging from 67.4% (fetal movement) to 85.3% (physical activity), and the total number of data points was over 6 million. Biospecimens, including maternal plasma, serum, urine, saliva, dental plaque and cord blood, were collected for multiomics analysis. FUTURE PLANS Lifelog and multiomics data will be used to construct a time-course high-resolution reference catalogue of pregnancy. The reference catalogue will allow us to discover relationships among multidimensional phenotypes and novel risk markers in pregnancy for the future personalised early prediction of pregnancy complications.
Collapse
Affiliation(s)
- Junichi Sugawara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Daisuke Ochi
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Research Laboratories, NTT DoCoMo, Inc, Yokosuka, Japan
| | - Riu Yamashita
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Takafumi Yamauchi
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Research Laboratories, NTT DoCoMo, Inc, Yokosuka, Japan
| | - Daisuke Saigusa
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Maiko Wagata
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | | | - Yuki Harada
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Tomoko Shibata
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Takahiro Mimori
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Junko Kawashima
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Fumiki Katsuoka
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | | | - Soichi Ogishima
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | | | - Hiroaki Hashizume
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Naoko Minegishi
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Seizo Koshiba
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Osamu Tanabe
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Radiation Effects Research Foundation, Hiroshima, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kengo Kinoshita
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Shigeo Kure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuo Yaegashi
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Sendai, Japan
| | - Masayuki Yamamoto
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Hiyama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Research Laboratories, NTT DoCoMo, Inc, Yokosuka, Japan
| | - Masao Nagasaki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
17
|
Hanazawa T, Asayama K, Watabe D, Tanabe A, Satoh M, Inoue R, Hara A, Obara T, Kikuya M, Nomura K, Metoki H, Imai Y, Ohkubo T. Association Between Amplitude of Seasonal Variation in Self-Measured Home Blood Pressure and Cardiovascular Outcomes: HOMED-BP (Hypertension Objective Treatment Based on Measurement By Electrical Devices of Blood Pressure) Study. J Am Heart Assoc 2018; 7:JAHA.117.008509. [PMID: 29728372 PMCID: PMC6015300 DOI: 10.1161/jaha.117.008509] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The clinical significance of long‐term seasonal variations in self‐measured home blood pressure (BP) has not been elucidated for the cardiovascular disease prevention. Methods and Results Eligible 2787 patients were classified into 4 groups according to the magnitude of their seasonal variation in home BP, defined as an average of all increases in home BP from summer (July–August) to winter (January–February) combined with all decreases from winter to summer throughout the follow‐up period, namely inverse‐ (systolic/diastolic, <0/<0 mm Hg), small‐ (0–4.8/0–2.4 mm Hg), middle‐ (4.8–9.1/2.4–4.5 mm Hg), or large‐ (≥9.1/≥4.5 mm Hg) variation groups. The overall cardiovascular risks illustrated U‐shaped relationships across the groups, and hazard ratios for all cardiovascular outcomes compared with the small‐variation group were 3.07 (P=0.004) and 2.02 (P=0.041) in the inverse‐variation group and large‐variation group, respectively, based on systolic BP, and results were confirmatory for major adverse cardiovascular events. Furthermore, when the summer‐winter home BP difference was evaluated among patients who experienced titration and tapering of antihypertensive drugs depending on the season, the difference was significantly smaller in the early (September–November) than in the late (December–February) titration group (3.9/1.2 mm Hg versus 7.3/3.1 mm Hg, P<0.001) as well as in the early (March–May) than in the late (June–August) tapering group (4.4/2.1 mm Hg versus 7.1/3.4 mm Hg, P<0.001). Conclusions The small‐to‐middle seasonal variation in home BP (0–9.1/0–4.5 mm Hg), which may be partially attributed to earlier adjustment of antihypertensive medication, were associated with better cardiovascular outcomes.
Collapse
Affiliation(s)
- Tomohiro Hanazawa
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.,Japan Development and Medical Affairs, GlaxoSmithKline KK, Tokyo, Japan
| | - Kei Asayama
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan .,Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Daisuke Watabe
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.,Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Ayumi Tanabe
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Japan
| | - Ryusuke Inoue
- Department of Medical Informatics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Azusa Hara
- Department of Social Pharmacy and Public Health, Showa Pharmaceutical University, Tokyo, Japan
| | - Taku Obara
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization Tohoku University, Sendai, Japan
| | - Masahiro Kikuya
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization Tohoku University, Sendai, Japan
| | - Kyoko Nomura
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Department of Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Japan
| | - Yutaka Imai
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | | |
Collapse
|
18
|
Mikami Y, Takai Y, Era S, Ono Y, Saitoh M, Baba K, Suzuki H, Seki H. Differences in home blood pressure and pulse rates between singleton and twin pregnancies. J Int Med Res 2018; 46:1496-1504. [PMID: 29350079 PMCID: PMC6091819 DOI: 10.1177/0300060517727683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objectives To evaluate home blood pressure (HBP) measurements during pregnancy and postpartum and investigate differences between singleton and twin pregnancies. Methods This prospective study involved normotensive, pregnant women who were planning to give birth at Saitama Medical Centre, Saitama, Japan between September 2013 and March 2017. HBP and pulse rate were measured twice daily and clinical blood pressure values were determined from patient records. Results HBP values were available from 101 participants; 69 women with singleton and 32 women with twin pregnancies. Systolic BP was statistically significantly higher in twin pregnancies from 23 weeks of gestation until 8 weeks after delivery compared with singleton pregnancies. Pulse rate was also statistically significantly higher between 11 and 30 weeks gestation in women with twin pregnancies compared with those with singleton pregnancies. Conclusions BP monitoring is important in the management of twin pregnancies, especially during the later gestational weeks and postpartum period and HBP would facilitate this monitoring.
Collapse
Affiliation(s)
- Yukiko Mikami
- 1 Department of Obstetrics and Gynaecology, Saitama Medical Centre, Saitama Medical University, Japan
| | - Yasushi Takai
- 1 Department of Obstetrics and Gynaecology, Saitama Medical Centre, Saitama Medical University, Japan
| | - Sumiko Era
- 1 Department of Obstetrics and Gynaecology, Saitama Medical Centre, Saitama Medical University, Japan
| | - Yoshihisa Ono
- 1 Department of Obstetrics and Gynaecology, Saitama Medical Centre, Saitama Medical University, Japan
| | - Masahiro Saitoh
- 1 Department of Obstetrics and Gynaecology, Saitama Medical Centre, Saitama Medical University, Japan
| | - Kazunori Baba
- 1 Department of Obstetrics and Gynaecology, Saitama Medical Centre, Saitama Medical University, Japan
| | - Hiromichi Suzuki
- 2 Department of Nephrology, 439998 Musashino Tokushukai Hospital , Japan
| | - Hiroyuki Seki
- 1 Department of Obstetrics and Gynaecology, Saitama Medical Centre, Saitama Medical University, Japan
| |
Collapse
|
19
|
The impact of salt intake during and after pregnancy. Hypertens Res 2017; 41:1-5. [PMID: 29046520 DOI: 10.1038/hr.2017.90] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 06/27/2017] [Accepted: 06/28/2017] [Indexed: 12/25/2022]
Abstract
Although high blood pressure before pregnancy is associated with a risk of gestational hypertension and preeclampsia, no convincing evidence has been produced to show that dietary salt reduction helps in the prevention and treatment of hypertension during pregnancy. Thus the current guidelines do not recommend a sodium restriction during pregnancy to prevent gestational hypertension and the development of preeclampsia. However, the long-term impact of hypertensive disorders of pregnancy for life-threatening diseases later in life is a critical issue. Gestational hypertension could contribute to the risk of developing hypertension later in life, and recent studies have suggested that gestational hypertension and preeclampsia are linked to cardiovascular complications. In this article, we provide an overview of the current perspectives on the salt intake of pregnant women and consider both the short-term influence and the impact beyond the perinatal period.
Collapse
|
20
|
Mikami Y, Takai Y, Era S, Ono Y, Saitoh M, Baba K, Suzuki H, Seki H. Provisional criteria for the diagnosis of hypertension in pregnancy using home blood pressure measurements. Hypertens Res 2017; 40:679-684. [PMID: 28179623 PMCID: PMC5506245 DOI: 10.1038/hr.2017.6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/20/2016] [Accepted: 01/07/2017] [Indexed: 11/08/2022]
Abstract
Most guidelines for the management of hypertension define it as a home blood pressure (HBP) value >135/85 mm Hg. However, there is no reference HBP value to diagnose hypertension in pregnant women. Therefore, in this study, we analyzed HBP measurements of pregnant women to determine whether it is appropriate to use the criteria for non-pregnant subjects for pregnant women. The participants of this study were 100 singleton pregnant women who visited our hospital between September 2013 and September 2016. We lent sphygmomanometers to the patients so they could measure their BP at home twice daily, and we measured their clinical BP when they visited the hospital. Six patients developed hypertensive disorders in pregnancy, whereas there were 63 women without hypertension or other complications that may affect BP. In the normotensive pregnant women, HBP values significantly correlated with the clinical BP values. HBP values equivalent to a clinical BP of 140/90 mm Hg, determined using the standard major axis method, were 120.8/83.5 mm Hg, 126.0/85.2 mm Hg and 136.3/89.3 mm Hg in the first, second and third trimesters, respectively. In normotensive pregnant women, HBP levels that indicate a risk of hypertensive disorder in pregnancy may be lower than 135/85 mm Hg before 28 weeks of gestation.
Collapse
Affiliation(s)
- Yukiko Mikami
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Sumiko Era
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Yoshihisa Ono
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Masahiro Saitoh
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Kazunori Baba
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Hiromichi Suzuki
- Department of Nephrology, Musashino Tokushukai Hospital, Nishi-Tokyo city, Tokyo, Japan
| | - Hiroyuki Seki
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| |
Collapse
|
21
|
Oishi M, Tanaka K, Ishihara K, Iino K, Yokoyama Y, Mizunuma H. Results of a questionnaire survey on blood pressure management in hypertensive disorders of pregnancy in Aomori prefecture, Japan. HYPERTENSION RESEARCH IN PREGNANCY 2017. [DOI: 10.14390/jsshp.hrp2017-006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Maika Oishi
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine
| | - Kanji Tanaka
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine
| | - Kana Ishihara
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine
| | - Kaori Iino
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine
| | - Hideki Mizunuma
- Fukushima Medical Center for Children and Women, Fukushima Medical University
| |
Collapse
|
22
|
Seasonal variation in self-measured home blood pressure among patients on antihypertensive medications: HOMED-BP study. Hypertens Res 2016; 40:284-290. [DOI: 10.1038/hr.2016.133] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/03/2016] [Accepted: 08/12/2016] [Indexed: 01/20/2023]
|
23
|
Monitoring and evaluation of out-of-office blood pressure during pregnancy. Hypertens Res 2016; 40:107-109. [DOI: 10.1038/hr.2016.112] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 07/14/2016] [Accepted: 07/16/2016] [Indexed: 11/08/2022]
|
24
|
Lei Q, Zhou X, Zhou YH, Mai CY, Hou MM, Lv LJ, Duan DM, Wen JY, Lin XH, Wang PP, Ling XB, Li YM, Niu JM. Prehypertension During Normotensive Pregnancy and Postpartum Clustering of Cardiometabolic Risk Factors: A Prospective Cohort Study. Hypertension 2016; 68:455-63. [PMID: 27354425 DOI: 10.1161/hypertensionaha.116.07261] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 05/09/2016] [Indexed: 01/15/2023]
Abstract
The nonstratification of blood pressure (BP) levels may underestimate future cardiovascular risk in pregnant women who present with BP levels in the range of prehypertension (120-139/80-89 mm Hg). We prospectively evaluated the relationship between multiple antepartum BP measurements (from 11(+0) to 13(+6) weeks' gestation to term) and the occurrence of postpartum metabolic syndrome in 507 normotensive pregnant women after a live birth. By using latent class growth modeling, we identified the following 3 distinctive diastolic BP (DBP) trajectory groups: the low-J-shaped group (34.2%; DBP from 62.5±5.8 to 65.0±6.8 mm Hg), the moderate-U-shaped group (52.6%; DBP from 71.0±5.9 to 69.8±6.2 mm Hg), and the elevated-J-shaped group (13.2%; DBP from 76.2±6.7 to 81.8±4.8 mm Hg). Notably, the elevated-J-shaped trajectory group had mean DBP and systolic BP levels within the range of prehypertension from 37(+0) and 26(+0) weeks of pregnancy, respectively. Among the 309 women who completed the ≈1.6 years of postpartum follow-up, the women in the elevated-J-shaped group had greater odds of developing postpartum metabolic syndrome (adjusted odds ratio, 6.55; 95% confidence interval, 1.79-23.92; P=0.004) than the low-J-shaped group. Moreover, a parsimonious model incorporating DBP (membership in the elevated-J-shaped group but not in the DBP prehypertension group as identified by a single measurement) and elevated levels of fasting glucose (>4.99 mmol/L) and triglycerides (>3.14 mmol/L) at term was developed, with good discrimination and calibration for postpartum metabolic syndrome (c-statistic, 0.764; 95% confidence interval, 0.674-0.855; P<0.001). Therefore, prehypertension identified by DBP trajectories throughout pregnancy is an independent risk factor for predicting postpartum metabolic syndrome in normotensive pregnant women.
Collapse
Affiliation(s)
- Qiong Lei
- From the Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China (Q.L., Y.-H.Z., C.-Y.M., M.-M.H., L.-J.L., D.-M.D., J.-Y.W., X.-H.L., J.-M.N.); Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of PAPF, Tianjin, China (X.Z.,Y.-M.L.); Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada (P.P.W.); and Department of Surgery, Stanford University, Palo Alto, CA (X.B.L.)
| | - Xin Zhou
- From the Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China (Q.L., Y.-H.Z., C.-Y.M., M.-M.H., L.-J.L., D.-M.D., J.-Y.W., X.-H.L., J.-M.N.); Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of PAPF, Tianjin, China (X.Z.,Y.-M.L.); Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada (P.P.W.); and Department of Surgery, Stanford University, Palo Alto, CA (X.B.L.)
| | - Yu-Heng Zhou
- From the Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China (Q.L., Y.-H.Z., C.-Y.M., M.-M.H., L.-J.L., D.-M.D., J.-Y.W., X.-H.L., J.-M.N.); Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of PAPF, Tianjin, China (X.Z.,Y.-M.L.); Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada (P.P.W.); and Department of Surgery, Stanford University, Palo Alto, CA (X.B.L.)
| | - Cai-Yuan Mai
- From the Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China (Q.L., Y.-H.Z., C.-Y.M., M.-M.H., L.-J.L., D.-M.D., J.-Y.W., X.-H.L., J.-M.N.); Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of PAPF, Tianjin, China (X.Z.,Y.-M.L.); Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada (P.P.W.); and Department of Surgery, Stanford University, Palo Alto, CA (X.B.L.)
| | - Ming-Min Hou
- From the Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China (Q.L., Y.-H.Z., C.-Y.M., M.-M.H., L.-J.L., D.-M.D., J.-Y.W., X.-H.L., J.-M.N.); Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of PAPF, Tianjin, China (X.Z.,Y.-M.L.); Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada (P.P.W.); and Department of Surgery, Stanford University, Palo Alto, CA (X.B.L.)
| | - Li-Juan Lv
- From the Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China (Q.L., Y.-H.Z., C.-Y.M., M.-M.H., L.-J.L., D.-M.D., J.-Y.W., X.-H.L., J.-M.N.); Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of PAPF, Tianjin, China (X.Z.,Y.-M.L.); Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada (P.P.W.); and Department of Surgery, Stanford University, Palo Alto, CA (X.B.L.)
| | - Dong-Mei Duan
- From the Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China (Q.L., Y.-H.Z., C.-Y.M., M.-M.H., L.-J.L., D.-M.D., J.-Y.W., X.-H.L., J.-M.N.); Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of PAPF, Tianjin, China (X.Z.,Y.-M.L.); Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada (P.P.W.); and Department of Surgery, Stanford University, Palo Alto, CA (X.B.L.)
| | - Ji-Ying Wen
- From the Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China (Q.L., Y.-H.Z., C.-Y.M., M.-M.H., L.-J.L., D.-M.D., J.-Y.W., X.-H.L., J.-M.N.); Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of PAPF, Tianjin, China (X.Z.,Y.-M.L.); Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada (P.P.W.); and Department of Surgery, Stanford University, Palo Alto, CA (X.B.L.)
| | - Xiao-Hong Lin
- From the Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China (Q.L., Y.-H.Z., C.-Y.M., M.-M.H., L.-J.L., D.-M.D., J.-Y.W., X.-H.L., J.-M.N.); Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of PAPF, Tianjin, China (X.Z.,Y.-M.L.); Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada (P.P.W.); and Department of Surgery, Stanford University, Palo Alto, CA (X.B.L.)
| | - Peizhong P Wang
- From the Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China (Q.L., Y.-H.Z., C.-Y.M., M.-M.H., L.-J.L., D.-M.D., J.-Y.W., X.-H.L., J.-M.N.); Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of PAPF, Tianjin, China (X.Z.,Y.-M.L.); Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada (P.P.W.); and Department of Surgery, Stanford University, Palo Alto, CA (X.B.L.)
| | - Xuefeng B Ling
- From the Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China (Q.L., Y.-H.Z., C.-Y.M., M.-M.H., L.-J.L., D.-M.D., J.-Y.W., X.-H.L., J.-M.N.); Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of PAPF, Tianjin, China (X.Z.,Y.-M.L.); Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada (P.P.W.); and Department of Surgery, Stanford University, Palo Alto, CA (X.B.L.)
| | - Yu-Ming Li
- From the Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China (Q.L., Y.-H.Z., C.-Y.M., M.-M.H., L.-J.L., D.-M.D., J.-Y.W., X.-H.L., J.-M.N.); Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of PAPF, Tianjin, China (X.Z.,Y.-M.L.); Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada (P.P.W.); and Department of Surgery, Stanford University, Palo Alto, CA (X.B.L.).
| | - Jian-Min Niu
- From the Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China (Q.L., Y.-H.Z., C.-Y.M., M.-M.H., L.-J.L., D.-M.D., J.-Y.W., X.-H.L., J.-M.N.); Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of PAPF, Tianjin, China (X.Z.,Y.-M.L.); Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada (P.P.W.); and Department of Surgery, Stanford University, Palo Alto, CA (X.B.L.).
| |
Collapse
|
25
|
|
26
|
Maternal clinic and home blood pressure measurements during pregnancy and infant birth weight: the BOSHI study. Hypertens Res 2015; 39:151-7. [PMID: 26510783 DOI: 10.1038/hr.2015.108] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 08/12/2015] [Accepted: 09/02/2015] [Indexed: 01/05/2023]
Abstract
This prospective cohort study compared measurements of maternal home blood pressure (HBP) with clinic blood pressure (CBP) before 20 weeks' gestation to determine associations with the risk of delivering a lower birth weight infant. A total of 605 Japanese women were included. Exposures were initial CBP, made between 10 weeks 0 days and 19 weeks 0 days, and HBP for comparison made within 1 week of CBP. Outcome was infant's birth weight, categorized and ranked as follows: ⩾3500 g, 3000-3499 g, 2500-2999 g and <2500 g. The proportional odds model with possible confounding factors was applied to compare the associations between CBP and HBP on infant birth weight. When both CBP and HBP were included simultaneously, the adjusted odds ratios (ORs) per 1 standard deviation (1s.d.) increase in clinic and home diastolic BP (DBP) were 1.06 (95% confidence interval (CI): 0.87-1.30) and 1.28 (95% CI: 1.04-1.58), respectively. The adjusted ORs per 1s.d. increase in clinic and home mean arterial pressure (MAP) were 1.02 (95% CI: 0.83-1.24) and 1.29 (95% CI: 1.04-1.59), respectively. Systolic BP measurement was not associated with infant birth weight. In conclusion, high maternal home DBP and MAP before 20 weeks' gestation was associated with a higher risk of lower infant birth weight than clinic DBP and MAP. Therefore, in addition to CBP, it may be worth having pregnant women measure HBP to determine the risk of lower infant birth weight.
Collapse
|
27
|
Cois A, Ehrlich R. Socioeconomic Status Modifies the Seasonal Effect on Blood Pressure: Findings From a National Panel Study. Medicine (Baltimore) 2015; 94:e1389. [PMID: 26334893 PMCID: PMC4616516 DOI: 10.1097/md.0000000000001389] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Seasonal variations in blood pressure have been consistently reported. However, uncertainty remains about the size of the seasonal effect in different regions, and about factors that explain the differences observed across and within populations. Using data from a national panel study, we investigated seasonal variations in blood pressure in the South African adult population, and whether these variations differed across socioeconomic strata.We estimated age-specific seasonal effects on blood pressure using a multilevel structural equation model, with repeated measurements nested within subjects. Effect modification by socioeconomic status was assessed by repeating the analyses in the subpopulations defined by levels of education, household income per capita, and type of housing.In men and women, season had a statistically significant effect on blood pressure, with higher levels in winter and lower levels in summer. For systolic blood pressure, the magnitude of the seasonal effect was 4.25/4.21 mmHg (women/men) and was higher in the older age groups. For diastolic blood pressure, the effect size was 4.00/4.01 mmHg, with no evident age trend. Seasonal effects were higher among subjects in the lowest socioeconomic classes than in the highest, with differences between 2.4 and 7.7 mmHg, depending on gender, whether systolic or diastolic blood pressure, and socioeconomic status indicator.In the South African adult population, blood pressure shows seasonal variation modified by age and socioeconomic status. These variations have epidemiological, clinical, and public health implications, including the prospect of population level intervention to reduce elevated risk of cold weather cardiovascular morbidity.
Collapse
Affiliation(s)
- Annibale Cois
- From the Division of Epidemiology and Biostatistics (AC); and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa (RE)
| | | |
Collapse
|
28
|
Parity as a factor affecting the white-coat effect in pregnant women: the BOSHI study. Hypertens Res 2015; 38:770-5. [DOI: 10.1038/hr.2015.97] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 09/04/2014] [Accepted: 09/27/2014] [Indexed: 11/08/2022]
|
29
|
Salles GF, Schlüssel MM, Farias DR, Franco-Sena AB, Rebelo F, Lacerda EMA, Kac G. Blood pressure in healthy pregnancy and factors associated with no mid-trimester blood pressure drop: a prospective cohort study. Am J Hypertens 2015; 28:680-9. [PMID: 25376641 DOI: 10.1093/ajh/hpu204] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 09/25/2014] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The well-known mid-trimester drop in blood pressure (BP) during normal pregnancy was recently questioned. OBJECTIVE To describe longitudinal changes in BP during healthy pregnancies and to investigate factors associated with no mid-trimester drop in BP. METHODS A prospective cohort with 158 healthy pregnant women was followed up in a public health care center in Rio de Janeiro, Brazil. We used linear mixed-effects models to estimate longitudinal changes in systolic BP (SBP) and diastolic BP (DBP) during pregnancy. Poisson regression models were performed to identify factors associated with no mid-trimester drop in BP. RESULTS Significant mid-trimester increase in SBP (5.6 mm Hg; 95% confidence interval (CI) = 4.6-6.7) and DBP (4.4 mm Hg; 95% CI = 3.4-5.3) was observed in 44.3% and 39.9% of the sample, respectively. Women (37.1%) who had not a mid-trimester SBP drop still had a DBP drop. White skin color (incidence ratio (IR): 1.71; 95% CI = 1.22-2.39), family history of hypertension (IR: 1.93; 95% CI = 1.29-2.89), early pregnancy obesity (IR: 2.29; 95% CI = 1.27-4.11), outside temperature variation (IR: 1.45; 95% CI = 1.00-2.10), and gestational weight gain from the first to second trimester (IR: 1.71; 95% CI = 1.01-2.88 and IR: 2.32; 95% CI = 1.39-3.89 for second and third tertiles) were characteristics associated with no mid-trimester drop in SBP. The same characteristics were associated with no mid-trimester drop in DBP, except family history of hypertension and outside temperature variation. CONCLUSIONS Some women without a mid-trimester SBP drop still present a DBP drop. The different patterns of mid-trimester change in BP seem to be determined by preexisting and pregnancy-related factors.
Collapse
Affiliation(s)
- Gil F Salles
- Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michael M Schlüssel
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Dayana R Farias
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Beatriz Franco-Sena
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda Rebelo
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Elisa M A Lacerda
- Department of Nutrition and Dietetics, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;
| |
Collapse
|
30
|
Imai Y, Hosaka M, Elnagar N, Satoh M. Clinical significance of home blood pressure measurements for the prevention and management of high blood pressure. Clin Exp Pharmacol Physiol 2014; 41:37-45. [PMID: 23763494 DOI: 10.1111/1440-1681.12142] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 05/20/2013] [Accepted: 06/07/2013] [Indexed: 12/12/2022]
Abstract
1. Ambulatory blood pressure (ABP) monitoring (M) provides BP information at many points on any particular day during unrestricted routine daily activities, whereas home blood pressure (HBP) monitoring provides a lot of BP information obtained under fixed times and conditions over a long period of time, thus mean values of HBP provide high reproducibility, and thus an overall superiority compared with ABP. 2. HBP is at least equally or better able than ABP to predict hypertensive target organ damage and prognosis of cardiovascular disease. 3. HBPM allows for ongoing disease monitoring by patients, improves adherence to antihypertensive treatment, and can provide health-care providers with timely clinical data and direct and immediate feedback regarding diagnosis and treatment of hypertension. 4. HBPM provides BP information in relation to time; that is, BP in the morning, in the evening and at night during sleep, and it is an essential tool for the diagnosis of white-coat and masked hypertension. 5. HBPM yields minimal alerting affects and no or minimal placebo effect, and can therefore distinguish small, but significant, serial changes in BP. It is thus the most practical method for monitoring BP in the day-to-day management of hypertension. 6. The superiority of HBPM over ABPM and clinic BPM is apparent from almost all practical and clinical research perspectives.
Collapse
Affiliation(s)
- Yutaka Imai
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
| | | | | | | |
Collapse
|
31
|
Morikawa M, Yamada T, Yamada T, Cho K, Sato S, Minakami H. Seasonal variation in the prevalence of pregnancy-induced hypertension in Japanese women. J Obstet Gynaecol Res 2014; 40:926-31. [DOI: 10.1111/jog.12304] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 09/12/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Mamoru Morikawa
- Department of Obstetrics; Hokkaido University Graduate School of Medicine; Sapporo Hokkaido Japan
| | - Takashi Yamada
- Department of Obstetrics; Hokkaido University Graduate School of Medicine; Sapporo Hokkaido Japan
| | - Takahiro Yamada
- Department of Obstetrics; Hokkaido University Graduate School of Medicine; Sapporo Hokkaido Japan
| | - Kazutoshi Cho
- Department of Obstetrics; Hokkaido University Graduate School of Medicine; Sapporo Hokkaido Japan
| | - Shoji Sato
- Department of Obstetrics and Gynecology; Oita Prefectural Hospital; Oita Japan
| | - Hisanori Minakami
- Department of Obstetrics; Hokkaido University Graduate School of Medicine; Sapporo Hokkaido Japan
| |
Collapse
|
32
|
Chen Q, Wang J, Tian J, Tang X, Yu C, Marshall RJ, Chen D, Cao W, Zhan S, Lv J, Lee L, Hu Y. Association between ambient temperature and blood pressure and blood pressure regulators: 1831 hypertensive patients followed up for three years. PLoS One 2013; 8:e84522. [PMID: 24391962 PMCID: PMC3877276 DOI: 10.1371/journal.pone.0084522] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Accepted: 11/14/2013] [Indexed: 12/27/2022] Open
Abstract
Several studies have suggested an association between ambient air temperature and blood pressure. However, this has not been reliably confirmed by longitudinal studies. Also, whether the reaction to temperature stimulation is modified by other factors such as antihypertensive medication is rarely investigated. The present study explores the relationship between ambient temperature and blood pressure, without and with antihypertensive medication, in a study of 1,831 hypertensive patients followed up for three years, in two or four weekly check ups, accumulating 62,452 follow-up records. Both baseline and follow-up blood pressure showed an inverse association with ambient temperature, which explained 32.4% and 65.6% of variation of systolic blood pressure and diastolic blood pressure (P<0.05) respectively. The amplitude of individual blood pressure fluctuation with temperature throughout a year (a 29 degrees centigrade range) was 9.4/7.3 mmHg. Medication with angiotensin converting enzyme inhibitor benazepril attenuated the blood pressure fluctuation by 2.4/1.3 mmHg each year, though the inverse association of temperature and blood pressure remained. Gender, drinking behavior and body mass index were also found to modify the association between temperature and diastolic blood pressure. The results indicate that ambient temperature may negatively regulate blood pressure. Hypertensive patients should monitor and treat blood pressure more carefully in cold days, and it could be especially important for the males, thinner people and drinkers.
Collapse
Affiliation(s)
- Qing Chen
- Department of Hygienic Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, P. R. China
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Jinwei Wang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Jun Tian
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Xun Tang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Canqing Yu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Roger J. Marshall
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Dafang Chen
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Weihua Cao
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Siyan Zhan
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Jun Lv
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Liming Lee
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
| | - Yonghua Hu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P. R. China
- * E-mail:
| |
Collapse
|
33
|
Beltran AJ, Wu J, Laurent O. Associations of meteorology with adverse pregnancy outcomes: a systematic review of preeclampsia, preterm birth and birth weight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 11:91-172. [PMID: 24362545 PMCID: PMC3924438 DOI: 10.3390/ijerph110100091] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 11/25/2013] [Accepted: 11/27/2013] [Indexed: 11/24/2022]
Abstract
The relationships between meteorology and pregnancy outcomes are not well known. This article reviews available evidence on the relationships between seasonality or meteorology and three major pregnancy outcomes: the hypertensive disorders of pregnancy (including preeclampsia, eclampsia and gestational hypertension), gestational length and birth weight. In total 35, 28 and 27 studies were identified for each of these outcomes. The risks of preeclampsia appear higher for women with conception during the warmest months, and delivery in the coldest months of the year. Delivery in the coldest months is also associated with a higher eclampsia risk. Patterns of decreased gestational lengths have been observed for births in winter, as well as summer months. Most analytical studies also report decreases in gestational lengths associated with heat. Birth weights are lower for deliveries occurring in winter and in summer months. Only a limited number of studies have investigated the effects of barometric pressure on gestational length or the effects of temperature and sunshine exposure on birth weight, but these questions appear worth investigating further. Available results should encourage further etiological research aiming at enhancing our understanding of the relationships between meteorology and adverse pregnancy outcomes, ideally via harmonized multicentric studies.
Collapse
Affiliation(s)
| | - Jun Wu
- Program in Public Health, Anteater Instruction & Research Bldg (AIRB), 653 East Peltason Drive, University of California, Irvine, CA 92697, USA.
| | | |
Collapse
|
34
|
Imai Y. Clinical significance of home blood pressure and its possible practical application. Clin Exp Nephrol 2013; 18:24-40. [DOI: 10.1007/s10157-013-0831-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 06/14/2013] [Indexed: 10/26/2022]
|
35
|
Imai Y, Obara T, Asamaya K, Ohkubo T. The reason why home blood pressure measurements are preferred over clinic or ambulatory blood pressure in Japan. Hypertens Res 2013; 36:661-72. [DOI: 10.1038/hr.2013.38] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 01/17/2013] [Accepted: 01/18/2013] [Indexed: 11/09/2022]
|
36
|
Ishikuro M, Obara T, Metoki H, Ohkubo T, Yamamoto M, Akutsu K, Sakurai K, Iwama N, Katagiri M, Yagihashi K, Yaegashi N, Mori S, Suzuki M, Kuriyama S, Imai Y. Blood pressure measured in the clinic and at home during pregnancy among nulliparous and multiparous women: the BOSHI study. Am J Hypertens 2013; 26:141-8. [PMID: 23382338 DOI: 10.1093/ajh/hps002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hypertension during pregnancy can cause serious problems during delivery, such as stroke, premature delivery, or low birthweight. Nulliparity is believed to be a risk factor for hypertension during pregnancy. However, the relationship between parity and blood pressure determined at home during pregnancy is still unknown. METHODS We assessed the incidence of gestational hypertension or preeclampsia in 575 nulliparous and multiparous women. Also, we examined blood pressure measured in the clinic and at home among 530 normotensive pregnant women who received antenatal care at a maternity hospital in Japan. Clinic blood pressures (CBPs) were obtained by duplicate measurement at each antenatal care visit. The participants were also required to measure their own blood pressures every morning at home while they were pregnant. A linear mixed model was used for analysis of the blood pressure course throughout pregnancy. RESULTS A total of 315 nulliparous and 215 multiparous women were entered into this study (mean age, 30.1 ± 4.6 years and 33.0 ± 4.1 years, respectively). CBP levels during pregnancy among nulliparous women were significantly higher than among multiparous women (P = 0.02/P <0.0001 for systolic/diastolic blood pressure), whereas there were no significant differences in home blood pressure (HBP) levels during pregnancy between the two groups (P = 0.4/P = 0.2 for systolic/diastolic blood pressure). CONCLUSIONS HBP levels during pregnancy were shown not to differ between nulliparous and multiparous women, while CBP levels during pregnancy were higher among nulliparous than among multiparous women.
Collapse
Affiliation(s)
- Mami Ishikuro
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Imai Y, Kario K, Shimada K, Kawano Y, Hasebe N, Matsuura H, Tsuchihashi T, Ohkubo T, Kuwajima I, Miyakawa M. The Japanese Society of Hypertension Guidelines for Self-monitoring of Blood Pressure at Home (Second Edition). Hypertens Res 2012; 35:777-95. [PMID: 22863910 DOI: 10.1038/hr.2012.56] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yutaka Imai
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmacological Sciences, Sendai, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Ishikuro M, Obara T, Metoki H, Ohkubo T, Yamamoto M, Akutsu K, Sakurai K, Iwama N, Katagiri M, Yagihashi K, Yaegashi N, Mori S, Suzuki M, Kuriyama S, Imai Y. PP083. Clinic and out-of-clinic blood pressure changes during pregnancy by parity: Boshi study. Pregnancy Hypertens 2012; 2:285. [PMID: 26105405 DOI: 10.1016/j.preghy.2012.04.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Nulliparity is believed to be one of the risk factors for hypertension during pregnancy. However, the relationship between parity and out-of-clinic blood pressure during pregnancy is still unknown. OBJECTIVES The aim of this study was to evaluate clinic blood pressure and blood pressure measured at home during pregnancy among nulliparous and multiparous women. METHODS This study was a prospective cohort study. We examined blood pressure measured in the clinic and at home among 530 normotensive pregnant women who received antenatal care at a maternity hospital in Japan. Clinic blood pressures were obtained by duplicate measurements at each antenatal care visit. The participants were also required to measure their own blood pressures every morning at home while they were pregnant. A linear mixed model was used for analysis of the blood pressure course throughout pregnancy [1]. The SAS package (version 9.2) was used for the statistical analyses. RESULTS A total of 315 nulliparous and 215 multiparous women were entered into this study (mean ages 30.1±4.6years and 33.0±4.1years, respectively). Clinic blood pressure during pregnancy among nulliparous women was significantly higher than that among multiparous women (P=0.02/P<0.0001 for systolic/diastolic blood pressure), whereas there were no significant differences in blood pressure measured at home during pregnancy between them (P=0.42/P=0.22 for systolic/diastolic blood pressure). CONCLUSION Out-of-clinic blood pressure levels during pregnancy have been shown not to differ between nulliparous and multiparous women, while clinic blood pressure during pregnancy among nulliparous women is higher than that among multiparous women.
Collapse
Affiliation(s)
- M Ishikuro
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Japan
| | - T Obara
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Japan
| | - H Metoki
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Japan
| | - T Ohkubo
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan; Department of Health Science, Shiga University of Medical Science, Otsu, Japan
| | - M Yamamoto
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Japan
| | - K Akutsu
- Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences, Japan
| | - K Sakurai
- Department of Environmental Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - N Iwama
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Japan
| | - M Katagiri
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Japan
| | | | - N Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Japan
| | - S Mori
- Suzuki Memorial Hospital, Iwanuma, Japan
| | - M Suzuki
- Suzuki Memorial Hospital, Iwanuma, Japan
| | - S Kuriyama
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Japan
| | - Y Imai
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
| |
Collapse
|
39
|
Metoki H, Ohkubo T, Obara T, Akutsu K, Yamamoto M, Ishikuro M, Sakurai K, Iwama N, Katagiri M, Sugawara J, Hirose T, Sato M, Kikuya M, Yagihashi K, Matsubara Y, Yaegashi N, Mori S, Suzuki M, Imai Y. Daily Serial Hemodynamic Data During Pregnancy and Seasonal Variation: The BOSHI Study. Clin Exp Hypertens 2012; 34:290-6. [DOI: 10.3109/10641963.2012.681086] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
40
|
Response to Metoki. Hypertens Res 2012. [DOI: 10.1038/hr.2012.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
41
|
Ishikuro M, Obara T, Metoki H, Ohkubo T, Yaegashi N, Kuriyama S, Imai Y. Blood pressure changes during pregnancy. Hypertens Res 2012; 35:563-4; author reply 34. [DOI: 10.1038/hr.2012.33] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
42
|
Hoirisch-Clapauch S, Benchimol-Barbosa P. Markers of insulin resistance and sedentary lifestyle are predictors of preeclampsia in women with adverse obstetric results. Braz J Med Biol Res 2011; 44:1285-90. [DOI: 10.1590/s0100-879x2011007500139] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 09/30/2011] [Indexed: 11/21/2022] Open
|
43
|
|
44
|
Prediction of pregnancy-induced hypertension by a shift of blood pressure class according to the JSH 2009 guidelines. Hypertens Res 2011; 34:1203-8. [DOI: 10.1038/hr.2011.107] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
45
|
TePoel MRW, Saftlas AF, Wallis AB. Association of seasonality with hypertension in pregnancy: a systematic review. J Reprod Immunol 2011; 89:140-52. [PMID: 21513987 DOI: 10.1016/j.jri.2011.01.020] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Revised: 01/03/2011] [Accepted: 01/12/2011] [Indexed: 01/27/2023]
Abstract
A systematic literature review was conducted to examine all academic, peer-reviewed studies of seasonal or monthly variation in the prevalence of gestational hypertension, preeclampsia, or eclampsia. The objective was to test the hypothesis that prevalence rates are highest during the winter months in non-tropical regions and during wet or humid periods in tropical climates. The authors searched the epidemiological literature indexed in PubMed, cross-referenced bibliographic materials, and reviewed personal archives. Of 60 abstracts and articles screened, 20 met the final inclusion criteria. Studies included were published between 1938 and 2010. Despite differences in setting, data sources, study design, outcome definitions, and control of known risk factors, 16 separate studies (11 non-tropical and 5 tropical) concurred that prevalence rates were higher for winter delivery in non-tropical regions or delivery during wet or humid periods in tropical climates. Although the reasons for these patterns are unknown, seasonal variation in infectious diseases, environmental triggers of asthma, vitamin D levels, physiological responses to cold temperatures, healthcare access, and nutritional intake may all play a role.
Collapse
Affiliation(s)
- Megan R W TePoel
- Department of Epidemiology, University of Iowa College of Public Health, 200 Hawkins Drive, GH C21M, Iowa City, IA 52242, USA
| | | | | |
Collapse
|
46
|
Hozawa A, Kuriyama S, Shimazu T, Ohmori-Matsuda K, Tsuji I. Seasonal variation in home blood pressure measurements and relation to outside temperature in Japan. Clin Exp Hypertens 2011; 33:153-8. [PMID: 21271816 DOI: 10.3109/10641963.2010.531841] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Previous studies have suggested that outside temperature affects blood pressure (BP) levels. However, recently, due to a spreading heating system, the seasonal variation in BP levels might be smaller, especially in colder seasons when more heat is used. We used continuous measurements of home BP data to track seasonal variations of BP to analyze the relation between outside temperature and BP values. Among 213 volunteers who were asked to measure BP in September 2000, 79 participants (mean age 72.7 years, 60.0% women) measured BP at least once per month until August 2003 (36 months). The mean number of measurements was 19.0 times/month. Information on outside temperature was provided by the Japan Meteorological Agency. We used general linear models to analyze the relation between outside temperature and BP values. Blood pressure levels were lowest in the warmest months. However, the highest BP levels were not observed in the coldest month, but rather in March. A clear inverse association between temperature and BP values was evident only in periods when outside temperatures were above 10°C. When the outside temperature was ≥ 10°C, 1°C increment of outside temperature correspond to 0.40 and 0.28 mmHg decrease of systolic blood pressure (SBP) and diastolic blood pressure (DBP), whereas the corresponding values were 0.06 and 0.01 mmHg when the outside temperature was <10°C. In conclusion, inverse association between outside temperature and BP was observed only in warmer seasons.
Collapse
Affiliation(s)
- Atsushi Hozawa
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | | | | | | | | |
Collapse
|
47
|
Algert CS, Roberts CL, Shand AW, Morris JM, Ford JB. Seasonal variation in pregnancy hypertension is correlated with sunlight intensity. Am J Obstet Gynecol 2010; 203:215.e1-5. [PMID: 20537304 DOI: 10.1016/j.ajog.2010.04.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 02/05/2010] [Accepted: 04/12/2010] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine seasonality of pregnancy hypertension rates, and whether they related to sunlight levels around conception. STUDY DESIGN Data were obtained for 424,732 singleton pregnancies conceived from 2001 through 2005 in Australia. We analyzed monthly rates of pregnancy hypertension and preeclampsia in relation to monthly solar radiation. RESULTS Pregnancy hypertension rates, by month of conception, were lowest in autumn (7.3%) and highest in spring (8.9%). Higher sunlight intensity before delivery, but not around conception, was associated with decreased pregnancy hypertension (r = -0.67). Increased sunlight around conception may correlate with decreased rates of early-onset preeclampsia (r = -0.51; P = .09). CONCLUSION The correlation between sunlight after conception and pregnancy hypertension was opposite to that hypothesized; however, sunlight levels before delivery did correlate with lower hypertension rates. For sunlight or ambient temperature to explain seasonal variation, the plausible exposure window is the period before delivery, but this may not apply to early-onset preeclampsia.
Collapse
Affiliation(s)
- Charles S Algert
- Kolling Institute, University of Sydney, New South Wales, Australia
| | | | | | | | | |
Collapse
|
48
|
Takenaka T, Kojima E, Sueyoshi K, Sato T, Uchida K, Arai J, Hoshi H, Kato N, Takane H, Suzuki H. Seasonal Variations of Daily Changes in Blood Pressure Among Hypertensive Patients with End-Stage Renal Diseases. Clin Exp Hypertens 2010; 32:227-33. [DOI: 10.3109/10641963.2010.491887] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
49
|
OHKUBO T. Clinical, Epidemiological and Pharmacological Research on Cardiovascular Disease Based on Blood Pressure Variability. YAKUGAKU ZASSHI 2009; 129:699-708. [DOI: 10.1248/yakushi.129.699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Takayoshi OHKUBO
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences
| |
Collapse
|
50
|
Silva LM, Steegers EA, Burdorf A, Jaddoe VW, Arends LR, Hofman A, Mackenbach JP, Raat H. Response to Detection of Midpregnancy Fall in Blood Pressure by Out-of-Office Monitoring. Hypertension 2009. [DOI: 10.1161/hypertensionaha.108.125443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Lindsay M. Silva
- Generation R Study Group and, Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Eric A.P. Steegers
- Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W.V. Jaddoe
- Generation R Study Group and, Departments of Epidemiology and Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Lidia R. Arends
- Department of Biostatistics and, Institute of Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Johan P. Mackenbach
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|