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Abstract
Introduction: Increased aortic systolic BP (SBPao), pulse wave velocity (PWVao) and augmentation index of the aorta (AIXao) are associated with increased cardiovascular morbidity. These measures may also be increased prior to the development of adverse maternal and perinatal outcomes. The aim of this study was to evaluate the association between haemodynamic parameters and adverse outcomes in women with chronic hypertension (CHT).
Methods: Women recruited to the PANDA study (Pregnancy And chronic hypertension: NifeDipine versus lAbetalol as antihypertensive treatment) had Arteriograph (Tensio Med) readings taken while sitting. Brachial BP, central SBPao, AIXao and PWVao were measured between 12 and 23 + 6 weeks gestation. Pregnancy outcomes were recorded. Medians within each group were calculated and compared using the Mann–Whitney test.
Results: Of the 70 participants; 24% developed superimposed preeclampsia (SPE), and there was a 19% incidence of SGA-3 (GROW customised birthweight below the third percentile).
Conclusions: This study highlights interesting changes in vascular function in the second trimester in women with CHT, prior to the onset of superimposed pre-eclampsia or SGA-3. Assessing the impact of antihypertensive medication on these parameters may improve understanding of the mechanism of such treatments.