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Creatine kinase is associated with blood pressure during pregnancy
Deborah L Horjus1, Anouk Bokslag2, Barbara A Hutten3
1Amsterdam UMC, University of Amsterdam, Vascular Medicine.
Insights
Elevated plasma creatine kinase activity in early pregnancy is linked to higher blood pressure and severe gestational hypertension. This finding suggests creatine kinase may be a risk factor for pregnancy-induced hypertension.
Area of Science:
- Obstetrics and Gynecology
- Cardiovascular Health
- Biochemistry
Background:
- Hypertensive disorders during pregnancy present significant health risks and are linked to future hypertension.
- Plasma creatine kinase (CK) activity is a known independent risk factor for hypertension in the general population.
Purpose of the Study:
- To investigate the association between plasma creatine kinase activity and blood pressure during pregnancy.
- To determine if plasma creatine kinase activity is associated with hypertensive disorders in pregnancy.
Main Methods:
- Utilized data from the 'Amsterdam Born Children and their Development-study'.
- Employed multiple linear regression and logistic regression models to analyze associations.
- Evaluated plasma creatine kinase activity against blood pressure and hypertensive disorders (gestational hypertension, HELLP, preeclampsia, eclampsia).
Main Results:
- Plasma creatine kinase activity showed a significant association with all blood pressure outcomes in 3619 pregnant women.
- A notable association was observed with mean systolic blood pressure (SBP) throughout pregnancy.
- Severe gestational hypertension diagnosed before 34 weeks of gestation was significantly associated with plasma creatine kinase activity (OR 9.16).
Conclusions:
- Plasma creatine kinase activity in early pregnancy is associated with blood pressure levels during gestation.
- Elevated plasma creatine kinase activity is linked to severe gestational hypertension diagnosed before 34 weeks.
- No significant association was found between plasma creatine kinase activity and HELLP syndrome or preeclampsia.
Objective:
Hypertensive disorders in pregnancy pose a major burden during pregnancy and are also associated with an increased risk for hypertension later in life. Plasma creatine kinase activity is identified in the general population as an independent risk factor for hypertension. We hypothesize that plasma creatine kinase activity is similarly associated with blood pressure during pregnancy.
Methods:
Women who participated in the 'Amsterdam Born Children and their Development-study' were eligible for the current study. The associations between plasma creatine kinase activity and blood pressure measurements during pregnancy, and between plasma creatine kinase activity and hypertensive disorders in pregnancy (gestational hypertension, HELLP, preeclampsia and eclampsia) were evaluated using multiple linear regression and logistic regression models.
Results:
In 3619 pregnant women, plasma creatine kinase activity was significantly associated with all blood pressure outcomes. This was most pronounced for the mean SBP throughout pregnancy, with a regression coefficient of 3.48 mmHg (CI 1.67-5.28, P < 0.001) per 1-unit logCK. With respect to the hypertensive disorders in pregnancy, we found a significant association between severe gestational hypertension diagnosed before 34 weeks of gestation (OR 9.16, CI 1.32-63.86, P = 0.025) per 1-unit logCK activity. HELLP and preeclampsia were not significantly associated.
Conclusion:
Our data show that plasma creatine kinase activity measured in early pregnancy is associated with blood pressure during pregnancy and associated with severe gestational hypertension diagnosed before 34 weeks of gestation, whereas no significant association was found between creatine kinase and other hypertensive disorders in pregnancy.
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