Blood Pressure Variability in Pregnancy: an Opportunity to Develop Improved Prognostic and Risk Assessment Tools

Area of Science:

• Obstetrics and Gynecology
• Cardiology
• Public Health

Background:

• Hypertensive disorders of pregnancy (HDP) are linked to increased long-term cardiovascular disease (CVD) risk.
• Current CVD risk assessment tools do not integrate HDP history due to limited risk discrimination.
• Existing HDP diagnostic criteria rely on a binary blood pressure (BP) threshold.

Purpose of the Study:

• To review the mortality and morbidity associated with HDP.
• To explore the utility of blood pressure (BP) variability during pregnancy for identifying women at high risk for future CVD.
• To discuss potential improvements in CVD risk prediction by incorporating HDP and BP variability.

Main Methods:

• Review of existing literature on hypertensive disorders of pregnancy (HDP).
• Analysis of current diagnostic thresholds for HDP.
• Exploration of blood pressure (BP) variability as a potential CVD risk marker during pregnancy.

Main Results:

• HDP is associated with a significant increase in long-term CVD risk.
• Blood pressure (BP) variability during gestation shows promise as a marker for future CVD risk.
• Current risk prediction models lack the incorporation of HDP history.

Conclusions:

• Hypertensive disorders of pregnancy (HDP) confer a lasting risk of cardiovascular disease (CVD).
• Incorporating blood pressure (BP) variability into HDP diagnostic criteria may enhance long-term CVD risk prediction.
• Future research should focus on refining diagnostic criteria and risk assessment tools for HDP and associated CVD risk.