Hemodynamics of Gestational Hypertension: Pathophysiological and Clinical Considerations

Abstract

The hemodynamic profile of 26 patients with gestational hypertension (GH) was compared to that of 47 matched for gestational age normotensive pregnant women (NP). The patients with GK studied at 32 - 36 weeks of gestation had significantly higher cardiac index (CI) (4.81 versus 4.35 L/min/sqm, p < 0.01) than control patients. CI in GH group studied at 37 - 41 weeks of gestation was also higher than in their control counterparts (4.69 vs. 4.14 L/min/sqm, p < 0.02). The heart rate averaged 80.9 beats) min in this GH group, compared with 7 2.8 beats/min in a group of normotensive controls (p < 0.01). The calculated systemic vascular resistance did not differ between GH and NP groups, despite significant differences in arterial pressure. The fetal outcome in GH group was uneventful and it seems to be accounted for by normal values of vascular resistance in these patients. The hyper kinetic circulatory state in women with GH resembles the pattern described in early forms of essential hypertension in nonpregnant patients. It is concluded that hemodynamic observations in GH patients supports previous suggestions that this condition may represent a latent essential hypertension.