From the Department of Obstetrics and Gynecology (L.B., J.J.D., V.v.B., E.A.P.S.) and Department of Internal Medicine (J.V., J.E.R.v.L.), Erasmus Medical Center, Rotterdam, The Netherlands.
Hypertension. 2018 Mar;71(3):491-498. doi: 10.1161/HYPERTENSIONAHA.117.10338.
Preeclampsia increases the long-term risk of cardiovascular disease, possibly through occurrence of hypertension after delivery, such as masked hypertension, night-time hypertension, and an adverse systolic night-to-day blood pressure (BP) ratio. These types of hypertension are often unnoticed and can only be detected with ambulatory BP monitoring (ABPM). We aimed to determine hypertension prevalence and 24-hour BP pattern with ABPM and office BP measurements in women 1 year after severe preeclampsia. This is a retrospective cohort study. As part of a follow-up program after severe preeclampsia, 200 women underwent ABPM and an office BP measurement 1 year after delivery. We calculated hypertension prevalence (sustained hypertension, masked hypertension, and white-coat hypertension) and systolic night-to-day BP ratio (dipping pattern). Medical files and questionnaires provided information on preexisting hypertension and antihypertensive treatment. One year after delivery, 41.5% of women had hypertension (sustained hypertension, masked hypertension, or white-coat hypertension) with ABPM. Masked hypertension was most common (17.5%), followed by sustained hypertension (14.5%) and white-coat hypertension (9.5%). With sheer office BP measurement, only 24.0% of women would have been diagnosed hypertensive. Forty-six percent of women had a disadvantageous dipping pattern. Hypertension is common 1 year after experiencing severe preeclampsia. Masked hypertension and white-coat hypertension are risk factors for future cardiovascular disease and can only be diagnosed with ABPM. Therefore, ABPM should be offered to all these women at high risk of developing hypertension and possibly future cardiovascular disease.
子痫前期会增加心血管疾病的长期风险，可能是通过分娩后发生高血压，如隐匿性高血压、夜间高血压和不良的收缩压夜间-日间血压（BP）比值。这些类型的高血压通常未被察觉，只能通过动态血压监测（ABPM）检测到。我们旨在确定严重子痫前期 1 年后女性的高血压患病率和 24 小时 BP 模式与 ABPM 和诊室 BP 测量。这是一项回顾性队列研究。作为严重子痫前期随访计划的一部分，200 名女性在分娩后 1 年接受 ABPM 和诊室 BP 测量。我们计算了高血压患病率（持续性高血压、隐匿性高血压和白大衣高血压）和收缩压夜间-日间 BP 比值（下降模式）。医疗档案和问卷提供了关于先前存在的高血压和降压治疗的信息。分娩后 1 年，41.5%的女性通过 ABPM 患有高血压（持续性高血压、隐匿性高血压或白大衣高血压）。隐匿性高血压最常见（17.5%），其次是持续性高血压（14.5%）和白大衣高血压（9.5%）。仅通过诊室 BP 测量，只有 24.0%的女性会被诊断为高血压。46%的女性存在不利的下降模式。高血压在经历严重子痫前期 1 年后很常见。隐匿性高血压和白大衣高血压是未来心血管疾病的危险因素，只能通过 ABPM 诊断。因此，所有这些有发生高血压和可能未来发生心血管疾病风险的女性都应接受 ABPM 检查。
