Key result
Severe preeclampsia was a significant predictor of a nondipping blood pressure profile (35.5% vs 24.2%; OR 1.08, 95% CI 1.05-10.56, P<0.001) and diastolic dysfunction compared to mild preeclampsia.
Why the study?
Left ventricular diastolic dysfunction and nocturnal nondipping of blood pressure on ambulatory monitoring predict increased cardiovascular morbidity, but their postpartum presence in women with preeclampsia needed evaluation.
Are severe and recurrent preeclampsia predictors of nondipping blood pressure profile and diastolic dysfunction at 3 months postpartum in normotensive women?
Cohort (n=128)
Are severe and recurrent preeclampsia predictors of nondipping blood pressure profile and diastolic dysfunction at 3 months postpartum in normotensive women?
Odds Ratio: 1.08 (95% CI 1.05–10.56)
Absolute Event Rate: 35.5% vs 24.2%
p-value: p=<0.001
Women with a history of severe or recurrent preeclampsia are at increased risk for subclinical cardiovascular abnormalities, including nondipping blood pressure and diastolic dysfunction, detectable as early as 3 months postpartum.
May support targeted postpartum ABPM and echocardiography after severe or recurrent preeclampsia; hypothesis-generating and requires prospective validation before changing practice.
BACKGROUND: Left ventricular diastolic dysfunction and nocturnal "nondipping" of blood pressure detected via ambulatory blood pressure monitoring are predictors of increased cardiovascular morbidity. METHODS: A prospective cohort study including normotensive women with a history of preeclampsia in their current pregnancy was conducted. All cases were subjected to 24-hour ambulatory blood pressure monitoring and 2-dimensional transthoracic echocardiography 3 months after delivery. RESULTS: This study included 128 women with a mean (SD) age of 28.6 (5.1) years and a mean (SD) basal blood pressure of 123.1 (6.4)/74.6 (5.9) mm Hg. Among the participants, 90 (70.3%) exhibited an ambulatory blood pressure monitoring profile illustrating nocturnal blood pressure "dipping" (the mean night to day time blood pressure ratio ≤ 0.9), whereas 38 (29.7%) were nondippers. Diastolic dysfunction (impaired left ventricular relaxation) was present in 28 nondippers (73.7%), whereas none of the dippers exhibited diastolic dysfunction. Women with severe preeclampsia were more frequently nondippers (35.5% vs 24.2%; P = .02) and experienced diastolic dysfunction (29% vs 15%; P = .01) than were those with mild preeclampsia. Severe preeclampsia (odds ratio [OR], 1.08; 95% CI, 1.05-10.56; P < .001) and history of recurrent preeclampsia (OR, 1.36; 95% CI, 1.3-4.26; P ≤ .001) were significant predictors for nondipping status and diastolic dysfunction (OR, 1.55; 95% CI, 1.1-2.2; and OR, 1.23; 95% CI, 1.2-2.2, respectively; P < .05). CONCLUSION: Women with a history of preeclampsia were at higher risk for developing late cardiovascular events. The severity and recurrence of preeclampsia were significant predictors of both nondipping profile and diastolic dysfunction.
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Sayed et al. (2023) conducted a cohort in Preeclampsia (n=128). Severe preeclampsia vs. Mild preeclampsia was evaluated on Nondipping blood pressure profile (OR 1.08, 95% CI 1.05-10.56, p=<0.001). Severe preeclampsia was a significant predictor of a nondipping blood pressure profile (35.5% vs 24.2%; OR 1.08, 95% CI 1.05-10.56, P<0.001) and diastolic dysfunction compared to mild preeclampsia.
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