Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.
Institute of Cardiovascular Diseases of Vojvodina, 21208 Sremska Kamenica, Serbia.
Int J Mol Sci. 2024 Oct 21;25(20):11324. doi: 10.3390/ijms252011324.
Gestational hypertension (GH) and preeclampsia (PE) are associated with the onset of hypertension. This study aimed to investigate whether the blood pressure (BP) pattern in GH is associated with the prevalence of hypertension later in life. In this prospective cohort study pregnant women screened for GH underwent medical history, laboratory analysis, ambulatory blood pressure monitoring (AMBP), and transthoracic echocardiography (with left ventricular global longitudinal strain (LVGLS)) assessment. Overall, 138 GH (67 non-dippers and 71 dippers), 55 preeclamptic, and 72 normotensive pregnant controls were included. Women were followed in the postpartum period, first after 6 weeks and later on, for the occurrence of hypertension. The median follow-up was 8.97 years (8.23; 9.03). Non-dippers and PE compared with normotensives and dippers had a higher prevalence of hypertension onset ( < 0.01), as well as significantly reduced absolute values of LVGLS during pregnancy, after delivery, and at the time of onset of hypertension during follow-up ( < 0.01). Night-time diastolic BP, LVGLS, age, and left ventricular ejection fraction were the strongest predictors of postpartum onset of hypertension. The non-dipping BP pattern in GH was significantly associated with the onset of hypertension later in life, as well as with decreased systolic function.
妊娠期高血压(GH)和子痫前期(PE)与高血压的发生有关。本研究旨在探讨 GH 中的血压(BP)模式是否与以后生活中高血压的患病率有关。在这项前瞻性队列研究中,筛查出患有 GH 的孕妇进行了病史、实验室分析、动态血压监测(ABPM)和经胸超声心动图(左心室整体纵向应变(LVGLS))评估。共有 138 例 GH(67 例非杓型和 71 例杓型)、55 例子痫前期和 72 例正常血压孕妇被纳入研究。孕妇在产后期间进行随访,首先在产后 6 周后进行,然后在随访期间发生高血压时进行。中位随访时间为 8.97 年(8.23;9.03)。与正常血压者和杓型者相比,非杓型者和 PE 发生高血压的发生率更高(<0.01),并且在怀孕期间、分娩后以及随访期间高血压发生时,LVGLS 的绝对值明显降低(<0.01)。夜间舒张压、LVGLS、年龄和左心室射血分数是产后高血压发生的最强预测因子。GH 中的非杓型 BP 模式与以后生活中高血压的发生显著相关,并且与收缩功能降低有关。