CLINICAL VALUE OF THE IMPAIRED CIRCADIAN BLOOD PRESSURE PROFILE IN PREGNANT WOMEN; POSSIBILITIES FOR DRUG PREVENTION OF GESTATIONAL HYPERTENSIVE COMPLICATIONS


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Objective: to ascertain the clinical value of the impaired circadian blood pressure (BP) prof ile and to determine the possibilities of drug prevention of hypertensive complications in pregnant women. Subjects and methods. The trial enrolled 377 pregnant women aged 18 to 42 years (mean 28 years) with different forms of arterial hypertension (AH), who were allocated to 4 groups: pregnant women with chronic AH (CAH); those with baseline normal BP, who developed gestational AH (GAH) or preeclampsia (PE) after 20 weeks’ gestation; and those in whom the signs of PE were added to CAH (CAH+PE). At the end of the first trimester, in the second (20—22 weeks) and third (30—32 weeks) ones, the pregnant women underwent clinical and laboratory studies, 24-hour BP monitoring, and echocardiography. The outcomes of pregnancy and labor were retrospectively analyzed. Results. Gestational hypertensive complications develop gradually after the stage of autonomic and metabolic abnormalities, endothelial dysfunction, and vasodilatation deficiency, which manifest themselves as the higher values of peripheral vascular resistance and diastolic pressure, and impaired circadian rhythm of BP with its insufficient nocturnal lowering. Conclusion. The detection of the early markers of GAH and PE makes it possible to use the period of preclinical changes in the regulation of the cardiovascular system to implement measures for their correction. By taking into account the data on the specific features of the micro- and macroelement status in pregnant women and on magnesium deficiency before hypertensive complications, magnesium preparations (magnerot) can be regarded as possible therapy at this stage.

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Sobre autores

N. RUNIKHINA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

Email: n_runihina@oparina4.ru

N. SHARASHKINA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

B. BART

N.I. Pirogov Russian National Research Medical University

O. TKACHEVA

State Research Center for Preventive Medicine

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