Ambulatory arterial stiffness index and nocturnal blood pressure dipping in pregnancies complicated by hypertension

Abstract

Background: The study sets out to examine differences in arterial stiffness and nocturnal blood pressure dipping as outcomes in women with gestational hypertension compared with healthy pregnant women during pregnancy and 3 months after delivery.

Methods and results: We prospectively studied a cohort of 60 women during the third trimester of pregnancy; of them, 28 suffered pregnancy-induced hypertension or pre-eclampsia and 32 had uncomplicated singleton pregnancies. Subsequently, 42 of these were re-examined 3 months after delivery. In women with a hypertensive disorder, the nocturnal fall in blood pressure (dipping) was significantly smaller than in the normotensive group (systolic, P = 0·031; diastolic, P<0·001), but after pregnancy, this difference disappeared (systolic, P = 0·941; diastolic, P = 0·907). Ambulatory arterial stiffness index (AASI) assessed after pregnancy correlated inversely with fasting glucose level during pregnancy (r = -0·580, P = 0·018), both systolic (r = -0·651, P = 0·012) and diastolic (r = -0·687, P = 0·007) nocturnal dipping and total cholesterol concentration after pregnancy (r = -0·526, P = 0·036).

Conclusions: A hypertensive disorder during pregnancy was associated with a flattened circadian blood pressure response, which was restored after delivery. Higher arterial stiffness predicted the signs of postpartum metabolic syndrome and correlated also with non-dipping, especially postpartum.

Keywords: ambulatory arterial stiffness index; blood pressure; dipping; pregnancy.