Gestational Hypertension Treatment Using Central Blood Pressure

Early recognition of gestational hypertension and those at risk for preeclampsia represents a clinically important management objective for pregnant women. Identification of those at-risk permits focusing of resources where the need is greatest in the population of pregnant woman and for the developing fetus.

Unlike the vast majority of patients with chronic hypertension, where end-organ damage develops over years to decades and acute events have been preceded by the gradual damage to the organ over time, pregnancy is a relatively short period where dramatic physiologic changes occur. The effects of preeclampsia and eclampsia can be acute and life-threatening to both the woman and the fetus. Therefore, tools that can identify those at risk and assist in the management of gestational hypertension are necessary. Brachial BP monitoring remains a key tool, but non-invasive central aortic pressure monitoring can provide additional data that augment current management approaches.

Elevated central aortic pressure predicts preeclampsia. Elevated central aortic pressure appears to be more sensitive in assessing the risk of preeclampsia compared to brachial pressure. Brachial and central aortic pressures provide complimentary information for risk prediction and management decisions. Data supports the incorporation of central blood pressure monitoring into standard screening and for enhanced monitoring for women at risk for preeclampsia.