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First-Trimester BP Category Linked to Hypertensive Disorders

THURSDAY, June 27, 2019 -- First-trimester blood pressure (BP) category is associated with development of hypertensive disorders of pregnancy, according to a study published online June 27 in the American Journal of Obstetrics and Gynecology.

Alisse Hauspurg, M.D., from the University of Pittsburgh School of Medicine, and colleagues compared the frequency of hypertensive disorders of pregnancy among 8,899 women based on their BP category at a first-trimester study visit and their BP trajectory between study visits in the first and second trimesters.

The researchers found a significant correlation for first trimester BP category with both preeclampsia and gestational hypertension; increasing BP category correlated with an elevated risk for all hypertensive disorders of pregnancy. Elevated BP and stage 1 hypertension correlated with adjusted relative risks (aRR) of 1.54 and 2.16, respectively, for any hypertensive disorder of pregnancy. The highest risk for preeclampsia with severe features was seen in association with stage 1 hypertension (aRR, 2.48). Independent of BP category, both systolic and diastolic BP trajectories were significantly associated with risk for hypertensive disorders of pregnancy. For women with BP categorized as normal, the risk for any hypertensive disorder of pregnancy was increased with an upward systolic trajectory versus a downward systolic trajectory (aRR, 1.41).

"BP categories with lower thresholds than those traditionally used to identify individuals as hypertensive, may identify more women at risk for HDP (hypertensive disorders of pregnancy)," the authors write.

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Posted: June 2019

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