Saratov JOURNAL of Medical and Scientific Research

White coat hypertension in pregnant women: comparative assesment of risk factors, target organ damage and gestational outcomes

Year: 2025, volume 21 Issue: №3 Pages: 295-300
Heading: Cardiology Article type: Original article
Authors: Nikolenko E.S., Chulkov V.S., Syundyukova E.G., Chulkov Vl.S.
Organization: South Ural State Medical University, Yaroslav-the-Wise Novgorod State University
Summary:

Objective: to conduct a comparative assessment of risk factors, target organ damage, and gestation outcomes in pregnant women with AH and normal blood pressure (BP). Material and methods. The prospective cohort study included 88 pregnant women divided into two groups: group 1 (main group) (44 women with white coat hypertension) and group 2 (comparison group) (44 women with normal blood pressure). Clinical factors, 24-h BP monitoring parameters, the state of target organs (heart, kidneys, and blood vessels), and pregnancy course and outcomes were recorded. Results. Women with white coat hypertension compared with normotensive pregnant women had a higher prevalence of abdominal obesity (90.9% vs 47.7%; p<0.001) and history of preeclampsia (11.4% vs 0%; p=0.021), higher night-time systolic (SBP) and diastolic BP, daytime diastolic BP (p<0.001), night-time diastolic BP (p=0.006), daytime heart rate (HR) (p=0.006), left ventricular posterior wall thickness (p<0.001), interventricular septal thickness (p<0.001), relative wall thickness (p=0.003), left ventricular myocardial mass (p<0.001), left ventricular end-diastolic volume (p=0.020), intima-media thickness on the right (p=0.022) and left (p=0.006), right cardio-ankle vascular index (p=0.043), urine albumin/creatinine ratio (p<0.001). The course of pregnancy in women with white coat hypertension was more often complicated by gestational diabetes mellitus (79.5% vs 25%; p<0.001) and late preeclampsia (11.4% vs 0%; p=0.021). Conclusion. Pregnancy in women with white coat hypertension is characterized by an increased risk of developing structural and functional changes in target organs and a high frequency of complications compared to pregnant women with normal BP.

Bibliography:
1. Stryuk Rl, Bunin YuA, Gur'eva VM, et al. Diagnostics and treatment of cardiovascular diseases during pregnancy 2018. National recommendations. Russian journal of cardiology. 2018;23(7):156-200. DOI:10.15829/1560-4071-2018-7-156-200
2. Magee LA, Brown MA, Hall DR, et al. The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2022;27:148-69. DOI:10.1016/j.preghy.2021.09.008
3. Fang Y, Zuo L, Duan H, et al. Hypertension phenotypes and adverse pregnancy outcome-related office and ambulatory blood pressure thresholds during pregnancy: A retrospective cohort study. Hypertens Res. 2025;48(1):77-87. DOI:10.1038/s41440-024-01837-x
4. Nikolenko ES, Chulkov VS, Chulkov VS. Cardiometa-bolic profile and indicators of daily blood pressure monitoring in pregnant women with white coat arterial hypertension. South-Russian Journal of Therapeutic Practice. 2025;6(1):51-8. DOI :10.21886/2712-8156-2025-6-1-51-58
5. Sung SH, Cheng НМ, Wang KL, et al. White coat hypertension is more risky than prehypertension: Important role of arterial wave reflections. Hypertension. 2013;61(6):1346-53. DOI: 10.1161/HYPERTENSIONAHA.111.00569
6. Nikolenko ES, Chulkov VS, Syundyukova EG, et al. Prognostic value of placental growth factor (PIGF) in "white coat arterial hypertension" in pregnant women. Therapy. 2025;5(87):57-64. DOI:10.18565/therapy.2025.5.57-64
7. Kobalava ZhD, Konradi АО, Nedogoda SV, et al. Arterial hypertension in adults. Clinical guidelines 2024. Russian Journal of Cardiology. 2024;29(9):6117. DOI:10.15829/1550-4071-2024-6117
8. Preeclampsia. Eclampsia. Edema, proteinuria and hypertensive disorders during pregnancy, childbirth and postpartum period: clinical guidelines. URL: https://cr.minzdrav.gov.ru/preview-cr/637_2 (25Aug 2025).
9. De Backer J, Haugaa KH, Hasselberg NE, et al. 2025 ESC Guidelines for the management of cardiovascular disease and pregnancy. Eur Heart J. 2025:ehaf193. DOI:10.1093/eur-heartj/ehaf193
10. Duffy JMN, Cairns AE, Magee LA, et al. Standardising definitions for the pre-eclampsia core outcome set: A consensus development study. Pregnancy Hypertens. 2020;21:208-17. DOI:10.1016/j.preghy.2020.06.005
11. Shlomai G, Grassi G, Grossman E, et al. Assessment of target organ damage in the evaluation and follow-up of hypertensive patients: where do we stand? J Clin Hypertens (Greenwich). 2013;15(10):742-7. DOM 0.1111/jch.12185
12. Johnson S, Gordijn S, Damhuis S, et al. Diagnosis and monitoring of white coat hypertension in pregnancy: An ISSHP Consensus Delphi Procedure. Hypertension. 2022;79(5):993-1005. DOMO.1161/HYPERTENSIONAHA.121.18356
13. Johnson S, Liu B, Kalafat E, et al. Maternal and perinatal outcomes of white coat hypertension during pregnancy: A systematic review and meta-analysis. Hypertension. 2020;76(1 ):157-66. DOI:10.1161/HYPERTENSIONAHA.119.14627
14. Rodrigues A, Barata C, Marques I, et al. Diagnosis of white coat hypertension and pregnancy outcomes. Pregnancy Hypertens. 2018;14:121-4. DOI:10.1016/j.preghy.2018.08.452
15. Taskina VYu, Demkina AE, Vladzimirsky AV, et al. Remote outpatient monitoring in obstetrics: state of the problem and prospects. Obstetrics and Gynecology. 2021;(9): 12-20. DOI: 10.18565/aig.2021.9.12-20
16. Savinova TL, Grudkin AA, Ermolaeva IV, et al. Remote monitoring of pregnant women: the experience of Orenburg. Obstetrics and Gynecology. 2024;(11):162-72. DOI: 10.18565/aig.2024.212. DOM 0.18565/aig.2024.212
17. Chulkov VS, Nikolenko E, Chulkov V, Podzolko A. White-coat hypertension in pregnant women: risk factors, pregnancy outcomes, and biomarkers. Folia Med (Plovdiv). 2023;65(4): 539-45. DOI:10.3897/folmed.65.e99159

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