Key result
High BP variability in pregnancy linked to worse LA function and increased gestational hypertension.
Why the study?
The relationship between left atrial abnormalities and ambulatory blood pressure variability in pregnant women and their link to hypertension-related clinical outcomes was not well understood.
Does high blood pressure variability affect left atrial function and predict hypertension-related clinical outcomes in pregnant women?
Observational (n=119)
No
Does high blood pressure variability affect left atrial function and predict hypertension-related clinical outcomes in pregnant women?
Higher blood pressure variability in early pregnancy is associated with worse left atrial function and predicts hypertension-related clinical outcomes.
BP variability may flag early LA strain in pregnancy; hypothesis-generating and should not yet change practice.
BACKGROUND: The aim of this study was to investigate the relationship between left atrial (LA) abnormalities and ambulatory blood pressure variability (BPV) in pregnant women and their relationship with hypertension-related clinical outcomes in pregnancy. METHODS: This single-center, prospective study included 119 pregnant women. All participants underwent 24-h ambulatory blood pressure (BP) monitoring and echocardiographic examination before 20 weeks of gestation. BPV was evaluated using 24-h ambulatory BP monitoring. SD of the mean of SBP (SBP-SD) and DBP variability was calculated as 24-h, daytime and nighttime SBP and DBP. The patients were classified into two groups based on median 24-h SBP-SD (11.3 mmHg). LA features of the patients were compared according to the high and low BPV groups. RESULTS: One hundred and nineteen pregnant women (mean age, 28.6 ± 5.2 years) were included in the study. The mean office SBP and DBP were 108.7 ± 15.4 mmHg and 68.2 ± 10.2 mmHg, respectively. In pregnant women with high BPV, even though BP is normal, reservoir and conduit LA functions have decreased and LA stiffness has increased. Gestational hypertension and composite outcomes were more common in pregnant women with high BPV. Among the LA parameters, the most associated with composite outcome was conduit LA function. CONCLUSION: In pregnancy, higher BPV is associated with worse LA function. The LA conduit strain offers potential value in predicting hypertension-related clinical outcomes in pregnancy.
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Murat et al. (2022) conducted an observational in Pregnancy (n=119). High blood pressure variability vs. Low blood pressure variability was evaluated on Left atrial function and hypertension-related clinical outcomes. High blood pressure variability in pregnancy is associated with worse left atrial function and a higher incidence of gestational hypertension and composite clinical outcomes.
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