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Ambulatory blood pressure in pregnancy. reference limits from an italian population
232A
AJH–APRIL 2000 –VOL. 13, NO. 4, PART 2
ASH XV ABSTRACTS
comparisons (Tukey’s test) showed that 24-h SBP decreased significantly at P2 with respect to P0, P1, P4 and P5; a significant DBP fall was already appreciable at P1, reaching a nadir at P2 and slowly approaching P0 values in late pregnancy. Heart rate showed a progressive rise. SBP, DBP and HR 24-h means SE are shown in the Figure. Ambulatory monitoring properly describes maternal hemodynamic changes in pregnancy.
DBP
SBP
Period
M ⴞ SD
94% CL
Upper 90% TL
95th centile
5–14 14–20 21–25 26–30 ⬎30 5–14 14–20 21–25 26–30 ⬎30
65.0 ⫾ 6.4 62.8 ⫾ 6.1 65.1 ⫾ 6.0 65.8 ⫾ 6.5 67.4 ⫾ 5.9 106.8 ⫾ 9.2 104.0 ⫾ 8.5 106.3 ⫾ 7.9 106.9 ⫾ 8.4 107.9 ⫾ 7.9
76 73 75 77 77 122 118 120 121 121
77 74 76 78 78 124 119 121 122 123
76 74 77 77 79 123 118 122 122 124
limit of the 90% tolerance interval has, with a 95% confidence, only a 5% chance of being normal. Key Words: Blood pressure; pregnancy; ambulatory monitoring; reference limits C062 IS AMBULATORY BLOOD PRESSURE MONITORING ACCURATE IN PATIENTS WITH CHRONIC ATRIAL FIBRILLATION? L. Almeida, P. Amado, J. Carmona, J. Nazare´, N. Vasconcelos, I. Santos, C. Rodrigues, J. Alves. Egas Moniz Hospital, Lisbon, Portugal
Key Words: Blood pressure; pregnancy; ambulatory monitoring C061 AMBULATORY BLOOD PRESSURE IN PREGNANCY. REFERENCE LIMITS FROM AN ITALIAN POPULATION R. Livi*, L. Teghini, E. Parretti, and G. Mello. Department of Internal Medicine and Department of Obstetrics and Gynecology, University of Florence, Italy To establish the upper limits of normality for ambulatory blood pressure (BP) at various gestational stages, 166 healthy women with uncomplicated pregnancies were cross-sectionally studied by 24 to 48-h ambulatory BP monitoring at one (n ⫽ 55) or more (n ⫽ 111) of 5 gestational periods (P1–P5, respectively at 5–14, 14 –20, 21–25, 26 –30 and ⬎30 weeks). A total of 29,426 valid BP measurements in 413 recordings was collected. In each gestational period, individual BP means were normally distributed (Kolmogorov-Smirnov test). Reference limits of normality were obtained for systolic (SBP) and diastolic (DBP) 24-h, activity and rest BP. Limits were computed as the 95% confidence limit (CL), the upper 90% tolerance limit (TL) with 90% confidence, and the 95th centile. Upper reference limits of normality for 24-h SBP and DBP are in the Table. All these limits share, with different statistical meaning, the characteristic of including the 95% of ambulatory BP means derived from a normal population of pregnant women. For example, the finding of a 24-h BP value above the upper
Atrial fibrillation (AF) is commonly seen in pacientes (pts) with systemic hypertension. They are usually excluded from ambulatory blood pressure monitoring (ABPM) because its accuracy is unknown. The aim of our study was to determine if ABPM can be used to assess 24 hour BP in pts with AE. We included hypertensive pts with chronic (⬎6 months), controlled heart rate (60 –100 c.p.m.) AF, under therapy. They were submitted to 24h ABPM (Spacelabs 90207). Manual BP with a standard mercury sphygmomanometer was taken during 3 visits (office BP) and in the day of ambulatory registration (CBP). Simultaneous measurements with a T-Tube were also performed. Thirty pts chronic AF (63% males), mean age 73 ⫾ 8 years (52– 85) were studied. The proportion of successful measurements was 94 ⫾ 8% (65–98) with 93% ⬎ 80%. In 64 simultaneous measurements the differences were 6 ⫹ 5 and 5 ⫹ 5 mmHg for systolic and diastolic BP.
Systolic BP Diastolic BP HR
Office BP
p
Daytime BP
p
CBP
144 ⫾ 16 83 ⫾ 9 76 ⫾ 7
NS NS NS
137 ⫾ 19 82 ⫾ 12 76 ⫾ 12
0,04 NS NS
148 ⫾ 21 85 ⫾ 10 78 ⫾ 10
In conclusion, this study demonstrates that ABPM can be used to assess BP in patients with chronic controlled atrial fibrillation. There was a high percentage of successful recordings (93%). In our patients there was also no significant difference in the mean office BP and daytime ambulatory pressure. Key Words: Atrial fibrillation, sistemic hypertension, ABPM
AJH–APRIL 2000 –VOL. 13, NO. 4, PART 2
ASH XV ABSTRACTS
comparisons (Tukey’s test) showed that 24-h SBP decreased significantly at P2 with respect to P0, P1, P4 and P5; a significant DBP fall was already appreciable at P1, reaching a nadir at P2 and slowly approaching P0 values in late pregnancy. Heart rate showed a progressive rise. SBP, DBP and HR 24-h means SE are shown in the Figure. Ambulatory monitoring properly describes maternal hemodynamic changes in pregnancy.
DBP
SBP
Period
M ⴞ SD
94% CL
Upper 90% TL
95th centile
5–14 14–20 21–25 26–30 ⬎30 5–14 14–20 21–25 26–30 ⬎30
65.0 ⫾ 6.4 62.8 ⫾ 6.1 65.1 ⫾ 6.0 65.8 ⫾ 6.5 67.4 ⫾ 5.9 106.8 ⫾ 9.2 104.0 ⫾ 8.5 106.3 ⫾ 7.9 106.9 ⫾ 8.4 107.9 ⫾ 7.9
76 73 75 77 77 122 118 120 121 121
77 74 76 78 78 124 119 121 122 123
76 74 77 77 79 123 118 122 122 124
limit of the 90% tolerance interval has, with a 95% confidence, only a 5% chance of being normal. Key Words: Blood pressure; pregnancy; ambulatory monitoring; reference limits C062 IS AMBULATORY BLOOD PRESSURE MONITORING ACCURATE IN PATIENTS WITH CHRONIC ATRIAL FIBRILLATION? L. Almeida, P. Amado, J. Carmona, J. Nazare´, N. Vasconcelos, I. Santos, C. Rodrigues, J. Alves. Egas Moniz Hospital, Lisbon, Portugal
Key Words: Blood pressure; pregnancy; ambulatory monitoring C061 AMBULATORY BLOOD PRESSURE IN PREGNANCY. REFERENCE LIMITS FROM AN ITALIAN POPULATION R. Livi*, L. Teghini, E. Parretti, and G. Mello. Department of Internal Medicine and Department of Obstetrics and Gynecology, University of Florence, Italy To establish the upper limits of normality for ambulatory blood pressure (BP) at various gestational stages, 166 healthy women with uncomplicated pregnancies were cross-sectionally studied by 24 to 48-h ambulatory BP monitoring at one (n ⫽ 55) or more (n ⫽ 111) of 5 gestational periods (P1–P5, respectively at 5–14, 14 –20, 21–25, 26 –30 and ⬎30 weeks). A total of 29,426 valid BP measurements in 413 recordings was collected. In each gestational period, individual BP means were normally distributed (Kolmogorov-Smirnov test). Reference limits of normality were obtained for systolic (SBP) and diastolic (DBP) 24-h, activity and rest BP. Limits were computed as the 95% confidence limit (CL), the upper 90% tolerance limit (TL) with 90% confidence, and the 95th centile. Upper reference limits of normality for 24-h SBP and DBP are in the Table. All these limits share, with different statistical meaning, the characteristic of including the 95% of ambulatory BP means derived from a normal population of pregnant women. For example, the finding of a 24-h BP value above the upper
Atrial fibrillation (AF) is commonly seen in pacientes (pts) with systemic hypertension. They are usually excluded from ambulatory blood pressure monitoring (ABPM) because its accuracy is unknown. The aim of our study was to determine if ABPM can be used to assess 24 hour BP in pts with AE. We included hypertensive pts with chronic (⬎6 months), controlled heart rate (60 –100 c.p.m.) AF, under therapy. They were submitted to 24h ABPM (Spacelabs 90207). Manual BP with a standard mercury sphygmomanometer was taken during 3 visits (office BP) and in the day of ambulatory registration (CBP). Simultaneous measurements with a T-Tube were also performed. Thirty pts chronic AF (63% males), mean age 73 ⫾ 8 years (52– 85) were studied. The proportion of successful measurements was 94 ⫾ 8% (65–98) with 93% ⬎ 80%. In 64 simultaneous measurements the differences were 6 ⫹ 5 and 5 ⫹ 5 mmHg for systolic and diastolic BP.
Systolic BP Diastolic BP HR
Office BP
p
Daytime BP
p
CBP
144 ⫾ 16 83 ⫾ 9 76 ⫾ 7
NS NS NS
137 ⫾ 19 82 ⫾ 12 76 ⫾ 12
0,04 NS NS
148 ⫾ 21 85 ⫾ 10 78 ⫾ 10
In conclusion, this study demonstrates that ABPM can be used to assess BP in patients with chronic controlled atrial fibrillation. There was a high percentage of successful recordings (93%). In our patients there was also no significant difference in the mean office BP and daytime ambulatory pressure. Key Words: Atrial fibrillation, sistemic hypertension, ABPM