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Blood-pressure variability is associated with left-ventricular mechanics in patients with gestational hypertension and preeclampsia

Hypertension Research volume 44, pages 1625–1632 (2021)Cite this article

Abstract

We aimed to investigate short- and long-term blood-pressure (BP) variability and left-ventricular (LV) structure, function, and mechanics in women with gestational hypertension and preeclampsia, as well as the relationship between BP variability and LV mechanics. This cross-sectional study included 140 pregnant women (45 normotensive controls, 50 patients with gestational hypertension and, 45 patients with preeclampsia) after 20 weeks of gestation. All participants underwent 24-h ambulatory BP monitoring and echocardiographic examination, as well as regular clinical BP measurements during each visit. Our results show that 24-h, daytime and nighttime systolic and diastolic BP, as well as visit-to-visit systolic and diastolic BPs, gradually increased from controls across patients with preeclampsia to those with gestational hypertension. Similar changes were observed for 24-h systolic BP-variability indices. LV longitudinal and circumferential strains gradually decreased from controls across women with gestational hypertension to patients with preeclampsia. Radial strain was significantly lower in women with preeclampsia than in controls. Indices of short- and long-term BP variability were independent of BP and demographic and echocardiographic parameters associated with LV longitudinal and circumferential strain. In conclusion, LV mechanics are impaired in women with gestational hypertension and preeclampsia compared with LV mechanics in normotensive controls. Short- and long-term BP variability was higher in patients with hypertensive disorders and was significantly associated with longitudinal and circumferential strains.

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Authors and Affiliations

  1. University Clinical Hospital Center “Dr. Dragisa Misovic - Dedinje”, Clinic for Internal Medicine, Cardiology Department, Heroja Milana Tepica 1, 11000, Belgrade, Serbia

    Marijana Tadic, Jelena Suzic-Lazic, Vladan Vukomanovic, Predrag Savic, Nikola Blagojevic & Vera Celic

  2. University of Milan-Bicocca and Istituto Auxologico Italiano, Clinical Research Unit Viale della Resistenza 23, 20036, Meda, Italy

    Cesare Cuspidi

  3. University Clinical Hospital Center “Dr. Dragisa Misovic - Dedinje”, Clinic for Gynecology, Heroja Milana Tepica 1, 11000, Belgrade, Serbia

    Sladjana Mihajlovic

  4. Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy

    Guido Grassi

Authors
  1. Marijana Tadic
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  2. Cesare Cuspidi
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  3. Jelena Suzic-Lazic
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  4. Vladan Vukomanovic
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  5. Sladjana Mihajlovic
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  6. Predrag Savic
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  7. Nikola Blagojevic
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  8. Guido Grassi
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  9. Vera Celic
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Contributions

MT contributed to the study design, analysis and writing the article, CC contributed to study design, interpretation of data and writing the article, JSZ, VV, SM, PS and NB contributed to the data collection and methodology, GG and VC contributed to the interpretation of data and revised it with important intellectual contribution.

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Correspondence to Marijana Tadic.

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Conflict of interest

Dr. Tadic is supported by the research grant of the European Society of Hypertension sponsored by Servier. Other authors have not declared any conflicts of interest related to this study.

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Tadic, M., Cuspidi, C., Suzic-Lazic, J. et al. Blood-pressure variability is associated with left-ventricular mechanics in patients with gestational hypertension and preeclampsia. Hypertens Res 44, 1625–1632 (2021). https://doi.org/10.1038/s41440-021-00768-1

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  • DOI: https://doi.org/10.1038/s41440-021-00768-1

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