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24‐hour blood pressure monitoring to evaluate the effects of nifedipine in pre‐eclampsia and in chronic hypertension in pregnancy
Author(s) -
Benedetto Chiara,
Zonca Marina,
Giarola Maurizio,
Maulà Vincenza,
Chiarolini Luciano,
Carandente Franca
Publication year - 1997
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1997.tb11978.x
Subject(s) - medicine , nifedipine , blood pressure , eclampsia , evening , pregnancy , population , diastole , anesthesia , cardiology , calcium , physics , environmental health , astronomy , biology , genetics
Objective To investigate the effect of 7 to 14 days of therapy with nifedipine (sustained‐release preparation) on the 24‐hour blood pressure patterns of pregnant women with pre‐eclampsia or chronic hypertension, and to test the utility of blood pressure monitoring in modulating the timing and dosage of the drug. Design 24‐hour automatic blood pressure monitoring of pregnant women with pre‐eclampsia or chronic hypertension before and after nifedipine treatment. Setting Centre for Prevention, Diagnosis and Treatment of Hypertension in Pregnancy, University of Turin, Italy. Population Sixteen pregnant women with pre‐eclampsia and 17 with chronic hypertension. Methods 24‐hour blood pressure monitoring was performed before the beginning of the therapy and after 7 to 14 days of treatment with sustained‐release nifedipine. Main outcome measures Chronobiological analysis of systolic and diastolic blood pressure values was performed; MESOR, amplitude, acrophase, hyperbaric index, percent time elevation and significance of rhythm were calculated before and after treatment. Results 6336 blood pressure measurements were analysed. Systolic and diastolic MESOR values were significantly decreased after nifedipine treatment both in pre‐eclampsia and in chronic hypertension. However, the antihypertensive effect of nifedipine in pre‐eclampsia was especially pronounced during evening and night, while in chronic hypertension it was more constant during the 24‐hour period. 24‐hour blood pressure monitoring allowed adjustment, when necessary, to the timing and dosage of nifedipine in accordance with the blood pressure patterns of each patient, using the hyperbaric index and percent time elevation as objective parameters for the evaluation of treatment efficacy. Conclusions 24‐hour blood pressure monitoring is a good method to optimise treatment, and confirms that nifedipine is useful for the control of maternal blood pressure in pregnancy.