[PP.24.04] AMBULATORY BLOOD PRESSURE MONITORING TO STRATIFY THE POSTPARTUM CARDIOVASCULAR RISK AFTER A PREECLAMPSIA: A PROSPECTIVE CONTROLLED STUDY

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Abstract

Objective:

Blunted nocturnal dip of blood pressure (BP) and reversed circadian rhythm have been described in pregnancies complicated by preeclampsia (PE). Non-dipper status and preeclampsia are both associated with an increased risk of cardiovascular and renal diseases later in life. The aim of this study was to assess the use of the 24h-ambulatory blood pressure monitoring (ABPM) in the stratification of post-partum cardiovascular risk after a PE by determining the prevalence of non-dipper status, masked and white coat hypertension.

Design and method:

We conducted a bi-centric, prospective controlled study on 115 women presenting with preeclampsia (61 women with severe PE, 54 with non-severe PE), compared to a control group of 41 women with no hypertensive disorders of pregnancy. Severity of PE was determined according to the International Society for the Study of Hypertension statement. Office BP measurements and 24h-ABPM were performed 6 to 12 weeks post-partum. Recruitment started in June 2010.

Results:

Characteristics of all groups are presented in Table 1 and 2. Among women having suffered from preeclampsia, 13.0 % of them were known for a preexistant hypertension before pregnancy, 30.4 % showed a persistent ambulatory hypertension at 6–12 weeks postpartum and 52.2% had an abnormal circadian pattern. Masked and white coat hypertensions were more frequent in women with PE (Table 3). There was no difference according to the severity of PE.

Conclusions:

One third of women who suffered from preeclampsia presented with a persistant ambulatory hypertension in the post-partum. The prevalence of masked and white coat hypertension was significantly higher in these women compared to women with a normal pregnancy. Identification of these high risk women with a 24h-ABPM 6 to 12 weeks after a preeclampsia allows an early implementation of preventive strategies.

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