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孕妇白大衣高血压:危险因素、妊娠结局和生物标志物。

White-coat hypertension in pregnant women: risk factors, pregnancy outcomes, and biomarkers.

机构信息

Yaroslav-the-Wise Novgorod State University, Veliky Novgorod, Russia.

South-Ural State Medical University, Chelyabinsk, Russia.

出版信息

Folia Med (Plovdiv). 2023 Aug 31;65(4):539-545. doi: 10.3897/folmed.65.e99159.

Abstract

Hypertensive disorders of pregnancy are a worldwide health problem for women. They cause complications in up to 10% of pregnancies and are associated with increased maternal and neonatal morbidity and mortality. Traditional blood pressure measurement in clinical practice is the most commonly used procedure for diagnosing and monitoring hypertension treatment, but it is prone to significant inaccuracies caused, on the one hand, by the inherent variability of blood pressure and, on the other, by errors arising from measurement technique and conditions. Some studies have demonstrated a better estimate of the prognosis for the development of cardiovascular diseases using ambulatory blood pressure monitoring. We can detect white-coat hypertension using this method, which helps to avoid overdiagnosis and overtreatment in many cases, and we can also detect masked hypertension, which helps to avoid underdiagnosis and a lack of prescribed treatment if needed. White-coat hypertension is not a benign condition - it has been shown to be associated with higher risks of developing preeclampsia, preterm birth, and small-for-gestational-age babies. In this regard, it is extremely important for clinicians to be aware of the risk factors and outcomes associated with this condition. Pregnant women should be medically monitored both during pregnancy and after delivery to detect target organ damage, cardiovascular risk factors, or a metabolic syndrome.

摘要

妊娠高血压疾病是全球范围内女性面临的健康问题。它会导致多达 10%的妊娠出现并发症,并与增加的母亲和新生儿发病率和死亡率相关。在临床实践中,传统的血压测量是诊断和监测高血压治疗最常用的程序,但它容易受到显著的不准确影响,一方面是由于血压的固有可变性,另一方面是由于测量技术和条件引起的误差。一些研究表明,使用动态血压监测可以更好地估计心血管疾病发展的预后。我们可以使用这种方法检测白大衣高血压,这有助于在许多情况下避免过度诊断和过度治疗,我们也可以检测到隐匿性高血压,如果需要,这有助于避免诊断不足和未规定治疗。白大衣高血压并不是一种良性情况 - 它已被证明与子痫前期、早产和小于胎龄儿的发生风险增加相关。在这方面,临床医生极有必要了解与这种情况相关的风险因素和结果。孕妇在怀孕期间和分娩后都应接受医学监测,以检测靶器官损伤、心血管危险因素或代谢综合征。

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