24-Hour blood pressure variability as a predictor of short-term echocardiographic changes in normotensive women with past history of preeclampsia/eclampsia

Abstract

Objectives: To investigate the association between 24-hr blood pressure variability (BPV) and subclinical echocardiographic changes and microalbuminuria in normotensive women with history of preeclampsia/eclampsia.

Background: Ambulatory blood pressure monitoring (ABPM) has been used as a valuable method in determining cardiovascular (CV) risk and target organ damage. Although hypertension and proteinuria that define preeclampsia/eclampsia may resolve in the majority of women, a significantly greater risk of CV and renal disease is present in their later life.

Methods: 101 normotensive women with a past history of preeclampsia/eclampsia and 42 age-matched normal volunteers were subjected to 24-hr ABPM, echocardiography for estimation of left ventricular mass (LVM) index and Aortic distensibility/stiffness indices. Urinary albumin/creatinine ratio was also estimated.

Results: There was significantly higher standard deviation (SD) and average reading variability (ARV) indices of BPV in the study group compared to controls (p < 0.001 for all). There were significantly higher LVM index, aortic stiffness index and microalbuminuria in the study group (p < 0.001 for all). There was significant positive correlation between all BPV indices and LVM index, aortic stiffness index (except for SD and ARV of diastolic BP for nighttime) and microalbuminuria. Stepwise regression analysis revealed that ARV of systolic BP for daytime can independently predict LVM index (r² = 0.688, p < 0.001), impaired aortic distensibility (r² = 0.557, p < 0.001) and microalbuminuria (r² = 0.696, p < 0.001).

Conclusions: The BPV indices correlated with subclinical echocardiographic changes and microalbuminuria in normotensive women with history of preeclampsia/eclampsia. The ARV of systolic BP for daytime could early predict such changes in those apparently healthy women.

Keywords: Aortic distensibility; Blood pressure variability; Left ventricular mass; Microalbuminuria; Preeclampsia/eclampsia.