Comparison between invasive and non-invasive assessment of blood pressure in hypertensive disorders of pregnancy

Ayman Khairy M Hassan, Ayman H Shaamash, Asmaa G Mohamed, Salwa R Demitry, Nady A Razik, Ayman Khairy M Hassan, Ayman H Shaamash, Asmaa G Mohamed, Salwa R Demitry, Nady A Razik

Abstract

Background: The management of hypertensive disorders of pregnancy (HDP) during hospitalization requires an accurate blood pressure (BP) measurement, mainly by invasive intra-arterial reading. Nevertheless, little is known about the precision of non-invasive (NI) central BP measurements in HDP. We aimed to assess the accuracy of NI central BP assessment in comparison to invasive BP measurement in HDP. This cross-sectional study included all patients with HDP that were admitted to university hospitals for high BP control, from December 2018 till December 2019, and 10 healthy matched non-hypertensive controls. Patients were compared for demographic, anthropometric, and echocardiographic data. In all subjects, invasive BP assessment was done by radial arterial cannulation and NI assessment of BP was performed by an oscillometric automated device (Mobil-O-Graph); the comparison was done after initial control of BP.

Results: One hundred patients were included and divided into 3 groups (pre-existing hypertension (HTN), gestational HTN, and pre-eclampsia). There was no statistically significant difference between NI central and invasive methods in measuring both systolic BP (SBP) (126.39 ± 14.5 vs 127.43 ± 15.3, p = 0.5) and diastolic BP (82.41 ± 9.0 vs 83.78 ± 8.9, p = 0.14) among the total studied population. A strong positive correlation was found between NI central and invasive SBP (r = 0.96, p < 0.001). HDP was associated with an increase in arterial stiffness, left ventricular diastolic dysfunction, and complications.

Conclusion: Non-invasive measurement of BP using oscillometric automated devices is as accurate as the invasive method, and it is a practical safe method in pregnant women with hypertensive disorders (CTR no. = NCT04303871).

Keywords: Hypertensive disorders of pregnancy; Invasive BP; Mobil-O-Graph; Oscillometric non-invasive BP.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Mean systolic blood pressure in invasive vs central non-invasive modality. b Mean diastolic BP in invasive vs central non-invasive modality. SBP, systolic blood pressure; DBP, diastolic blood pressure
Fig. 2
Fig. 2
Correlation between invasive (SBP/DBP) and noninvasive central (SBP/DBP) for the total patient population. BP, blood pressure; SBP, systolic blood pressure; DBP, diastolic blood pressure
Fig. 3
Fig. 3
Difference between central non-invasive BP and sphygmomanometer in both. a Mean Systolic blood pressure in non-invasive central vs sphygmomanometer modality. b Mean diastolic BP in noninvasive central vs sphygmomanometer modality. SBP, systolic blood pressure; DBP, diastolic blood pressure
Fig. 4
Fig. 4
a Augmentation index in different study groups (ANOVA test of difference showed a significant p value < 0.001), and b pulse wave velocity in the different study groups (p = 0.03). AIx, augmentation index; PWV, pulse wave velocity

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