Background In the non-pregnant population, national guidance recommends individualising the treatment of hypertension according to race. Ambulatory blood pressure monitoring (ABPM) provides a detailed blood pressure (BP) profile and provides information on nocturnal BP.
Determine the nocturnal BP dip in women with different ethnicity during pregnancy
Establish the BP variation over 24-hours for women taking calcium channel blockers (CCB) compared to those taking other antihypertensives (labetalol or methyldopa).
Method Women attending the Manchester Antenatal Vascular Service research clinic in the mid-trimester who were taking antihypertensive medication or whose BP was at the treatment threshold were offered 24-hour ABPM. The SpaceLabs 92506 ambulatory BP monitor was fitted.
Results Data was available for 17 patients. Six were of Afro-Caribbean origin. None of the Afro-Caribbean women had a nocturnal BP dip (≥10%) compared with 4/11 (36%) and 5/11 (45%) women from other ethnic origins for systolic and diastolic BP respectively (P = 0.07). The 24-hour variation in BP was not statistically different between ethnic groups. The systolic and diastolic load was significantly lower in Afro-Caribbean women, P = 0.004 and P = 0.003 respectively.
The 24-hour variation in MAP was similar for those on a CCB compared with those on other antihypertensives (CCB 7.9 vs other 9.1; P = 0.4).
Conclusion We have identified differences in 24-hour BP profiles and treatment effects between ethnic groups during pregnancy. Further research is necessary to determine the most effective antihypertensive for individual women during pregnancy.
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