Pulse pressure predicts pregnancy complications early
Source: Hypertension 2004; 44: 1-6
The circadian pattern of ambulatory pulse pressure can differentiate
gestational hypertension from pre-eclampsia as early as the second
Pulse pressure may be a more sensitive diagnostic marker of
pre-eclampsia than systolic or diastolic blood pressure (BP), Spanish
RamÃƒÂ³n Hermida (University of Vigo, Campus Universitario, Spain) and team
retrospectively analyzed serial BP measurements from 245 women with
uncomplicated pregnancies, 140 with gestational hypertension, and 49
patients who developed pre-eclampsia.
All participants underwent 48-hour ambulatory BP monitoring every 4
weeks from the first obstetric visit until delivery.
Hermida and co-authors report that 24-hour mean pulse pressure was
elevated in all trimesters of complicated pregnancies compared with
normal pregnancies. The difference achieved statistical significance.
Interestingly, 24-hour mean pulse pressure was not significantly greater
in women with pre-eclampsia than those with gestational hypertension in
the first trimester, but was increased in the second and third, by 1.44
mmHg and 1.8 mmHg, respectively.
"The differential changes in the circadian pattern of pulse pressure
with advancing gestational age demonstrated here offer new endpoints for
early diagnosis of gestational hypertension and pre-eclampsia based on
information obtained from ambulatory BP monitoring that could also be
used as a guide for establishing preventive interventions," conclude
Hermida et al.