Olofsson P, Poulsen H. Reversed circadian blood pressure rhythm preserves fetal growth in preeclamptic pregnancy.
Eur J Obstet Gynecol Reprod Biol 1997;
75:133-8. [PMID:
9447364 DOI:
10.1016/s0301-2115(97)00099-7]
[Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE
To determine the clinical trait of hypertension in pregnant women with a reversed circadian blood pressure (BP) rhythm.
STUDY DESIGN
24-h BP monitoring was performed in 56 hypertensive pregnant women, of whom 12 had a reversed systolic BP (SBP) rhythm (day/night mean BP ratio < 1.0). Clinical data, ultrasound fetometry and umbilical artery velocimetry were compared to that in women with a normal rhythm. Statistical analyses were performed with simple linear regression, Mann-Whitney U test, analysis of variance, contingency table analysis and Fisher's test. A two-tailed P value of < 0.05 was considered significant.
RESULTS
In the reversed SBP group, the nighttime BP, fetal weight, albuminuria and S-urate were higher, and the BP variations smaller. The birthweight correlated negatively to the SBP day/night ratio. Higher SBP day/night ratios and larger BP variations were associated with an increased vascular resistance in the umbilical artery and an impaired growth.
CONCLUSION
A reversed SBP rhythm was associated with a more severe degree of preeclampsia, but also with a smaller BP variation, maintenance of fetal growth, and higher birthweight. A sustained high nighttime BP preserved fetal growth. These novel observations challenge the opinion that a reversed circadian BP rhythm is merely an ominous sign.
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