Beat-to-Beat Blood Pressure Variability in the First Trimester Is Associated With the Development of Preeclampsia in a Prospective Cohort: Relation With Aortic Stiffness

Virginia R Nuckols; Seth W Holwerda; Rachel E Luehrs; Lyndsey E DuBose; Amy K Stroud; Debra Brandt; Alexandria M Betz; Jess G Fiedorowicz; Sabrina M Scroggins; Donna A Santillan; Justin L Grobe; Curt D Sigmund; Mark K Santillan; Gary L Pierce

doi:10.1161/HYPERTENSIONAHA.120.15019

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Beat-to-Beat Blood Pressure Variability in the First Trimester Is Associated With the Development of Preeclampsia in a Prospective Cohort: Relation With Aortic Stiffness

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Beat-to-Beat Blood Pressure Variability in the First Trimester Is Associated With the Development of Preeclampsia in a Prospective Cohort: Relation With Aortic Stiffness

Virginia R Nuckols, Seth W Holwerda, Rachel E Luehrs, Lyndsey E DuBose, Amy K Stroud, Debra Brandt, Alexandria M Betz, Jess G Fiedorowicz, Sabrina M Scroggins, Donna A Santillan, …

Hypertension (Dallas, Tex. 1979), Vol.76(6), pp.1800-1807

12/2020

DOI: 10.1161/HYPERTENSIONAHA.120.15019

PMCID: PMC7706825

PMID: 32951467

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Abstract

Women with preeclampsia, a hypertensive disorder of pregnancy, exhibit greater beat-to-beat blood pressure variability (BPV) in the third trimester after clinical onset of the disorder. However, it remains unknown whether elevated BPV precedes the development of preeclampsia. A prospective study cohort of 139 women (age 30.2±4.0 years) were enrolled in early pregnancy (<14 weeks gestation). BPV was quantified by time domain analyses of 10-minute continuous beat-to-beat blood pressure recordings via finger photoplethysmography in the first, second, and third trimesters. Aortic stiffness (carotid-femoral pulse wave velocity) and spontaneous cardiovagal baroreflex sensitivity were also measured each trimester. Eighteen women (13%) developed preeclampsia. Systolic BPV was higher in all trimesters among women who developed versus did not develop preeclampsia (first: 4.8±1.3 versus 3.7±1.2, =0.001; second: 5.1±1.8 versus 3.8±1.1, =0.02; third: 5.2±0.8 versus 4.0±1.1 mm Hg, =0.002). Elevated first trimester systolic BPV was associated with preeclampsia (odds ratio, 1.94 [95% CI, 1.27-2.99]), even after adjusting for risk factors (age, body mass index, systolic blood pressure, history of preeclampsia, and diabetes mellitus) and was a significant predictor of preeclampsia (area under the receiver operator characteristic curve=0.75±0.07; =0.002). Carotid-femoral pulse wave velocity was elevated in the first trimester among women who developed preeclampsia (5.9±0.8 versus 5.2±0.8 m/s; =0.002) and was associated with BPV after adjustment for mean blood pressure ( =0.26; =0.005). First trimester baroreflex sensitivity did not differ between groups ( =0.23) and was not related to BPV ( =0.36). Elevated systolic BPV is independently associated with the development of preeclampsia as early as the first trimester, possibly mediated in part by higher aortic stiffness.

Hypertension

blood pressure

preeclampsia

baroreflex

carotid-femoral pulse wave velocity

Details

Title: Subtitle: Beat-to-Beat Blood Pressure Variability in the First Trimester Is Associated With the Development of Preeclampsia in a Prospective Cohort: Relation With Aortic Stiffness
Creators: Virginia R Nuckols - From the Departments of Health and Human Physiology (V.R.N., S.W.H., R.E.L., L.E.D., A.K.S., G.L.P.), University of Iowa, Iowa City, IA
Seth W Holwerda - the Abboud Cardiovascular Research Center (S.W.H., M.K.S., G.L.P.), University of Iowa, Iowa City, IA
Rachel E Luehrs - From the Departments of Health and Human Physiology (V.R.N., S.W.H., R.E.L., L.E.D., A.K.S., G.L.P.), University of Iowa, Iowa City, IA
Lyndsey E DuBose - From the Departments of Health and Human Physiology (V.R.N., S.W.H., R.E.L., L.E.D., A.K.S., G.L.P.), University of Iowa, Iowa City, IA
Amy K Stroud - From the Departments of Health and Human Physiology (V.R.N., S.W.H., R.E.L., L.E.D., A.K.S., G.L.P.), University of Iowa, Iowa City, IA
Debra Brandt - Obstetrics and Gynecology (D.B., A.M.B., S.M.S., D.A.S., M.K.S.), University of Iowa, Iowa City, IA
Alexandria M Betz - Obstetrics and Gynecology (D.B., A.M.B., S.M.S., D.A.S., M.K.S.), University of Iowa, Iowa City, IA
Jess G Fiedorowicz - Internal Medicine (J.G.F.), University of Iowa, Iowa City, IA
Sabrina M Scroggins - Obstetrics and Gynecology (D.B., A.M.B., S.M.S., D.A.S., M.K.S.), University of Iowa, Iowa City, IA
Donna A Santillan - Obstetrics and Gynecology (D.B., A.M.B., S.M.S., D.A.S., M.K.S.), University of Iowa, Iowa City, IA
Justin L Grobe - Cardiovascular Research Center (J.L.G., C.D.S.), Medical College of Wisconsin, Milwaukee, WI
Curt D Sigmund - Cardiovascular Research Center (J.L.G., C.D.S.), Medical College of Wisconsin, Milwaukee, WI
Mark K Santillan - the Abboud Cardiovascular Research Center (S.W.H., M.K.S., G.L.P.), University of Iowa, Iowa City, IA
Gary L Pierce - Fraternal Order of Eagles Diabetes Research Center (G.L.P.), University of Iowa, Iowa City, IA
Resource Type: Journal article
Publication Details: Hypertension (Dallas, Tex. 1979), Vol.76(6), pp.1800-1807
DOI: 10.1161/HYPERTENSIONAHA.120.15019
PMID: 32951467
PMCID: PMC7706825
NLM abbreviation: Hypertension
ISSN: 0194-911X
eISSN: 1524-4563
Publisher: United States
Grant note: R01 HL134850 / NHLBI NIH HHS P01 HL084207 / NHLBI NIH HHS R35 HL144807 / NHLBI NIH HHS
Language: English
Date published: 12/2020
Academic Unit: Molecular Physiology and Biophysics; Psychiatry; Epidemiology; Iowa Neuroscience Institute; Obstetrics and Gynecology; Neuroscience and Pharmacology; Health, Sport, and Human Physiology ; Internal Medicine
Record Identifier: 9984070716902771

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