Patients at risk of masked hypertension may benefit from home blood pressure monitoring
Masked Pregnancy-Associated Hypertension as a Predictor of Adverse Outcomes
Pregnant women who have risk factors for preeclampsia may be advised by their health care provider to monitor their blood pressure at home. This can be particularly helpful for patients who experience “white coat hypertension”- when a patient’s blood pressure is normal outside of the doctors’ office, but higher when taken at a doctor’s appointment.
“Masked hypertension” is the opposite of “white coat hypertension.” Masked hypertension is when a patient has elevated blood pressure at home, but normal blood pressure readings in the doctors’ office. Researchers in this study asked: is masked hypertension in pregnancy associated with having a hypertensive disorder of pregnancy? In this study, 2,430 pregnant women who were self-monitoring their blood pressures at home were included in the analysis. All were patients within a single health care system but delivered across 6 hospitals in Louisiana. 7% (165 of 2,430) of the study population met the definition of masked hypertension – meaning their blood pressure at home was at least 140/90 mmHg twice before any high blood pressure diagnosis from office measured blood pressures. The researchers found the odds of adverse pregnancy outcomes of those patients were higher compared to patients with normal blood pressure. Rates of preeclampsia with severe features was 28% in the patients with masked hypertension (compared to 2%). Odds of preterm delivery, c-section delivery, having a baby that is small for gestational age, and having a baby admitted to the NICU were all significantly higher for patients with
masked hypertension compared to those with normal blood pressure.
Take Home Message: This study highlights the importance of self-monitoring of blood pressure outside of the doctors’ office during pregnancy to help identify women at risk for hypertension disorders of pregnancy and future delivery complications.
Link: https://pubmed.ncbi.nlm.nih.gov/37098390/
Citation: Mussarat N, Biggio J Jr, Martin J, Morgan J, Tivis R, Elmayan A, Williams FB. Masked pregnancy-associated hypertension as a predictor of adverse outcomes. Am J Obstet Gynecol MFM. 2023 Jul;5(7):100976. doi: 10.1016/j.ajogmf.2023.100976. Epub 2023 Apr 23. PMID: 37098390.
Related Articles
Your story is needed to improve outcomes for moms like you. Add your voice to critical preeclampsia research to ensure that every story is heard.
Frequently asked questions about the Preeclampsia Registry, a patient-driven registry and biobank.
The Preeclampsia Foundation offers research funding, study recruitment, and other patient engagement services to researchers.
We provide research grant funding to advance progress towards detection, prevention, or treatment of preeclampsia, HELLP syndrome, and other hypertensive disorders of pregnancy.
Recent findings in preeclampsia research have shown that preeclampsia likely has at least two variants – an early onset and a late onset variant. Early onset is typically defined as before 34 we...
Preeclampsia is a pregnancy complication marked by new-onset high blood pressure and signs of stress on organs such as the kidneys, liver, and brain. While much attention is often given to preterm dis...
Preeclampsia is a serious problem that can happen during pregnancy. It often affects the brain and can cause headaches, vision problems, strong reflexes, and seizures (called eclampsia). In this study...
Pregnancy offers a unique window into a woman’s future heart and cardiovascular health. Conditions such as hypertensive disorders of pregnancy (HDP) which include gestational hypertension, preec...
Heart disease, also called cardiovascular disease (CVD), is becoming more common in young women across the United States. Hypertensive disorders of pregnancy (HDP) is a group of conditions that includ...