Arterial hypertension in pregnant women: the effect of body mass index and smoking

Abstract Aim To evaluate the effect of body mass index (BMI) and smoking, as well as their combination on the development of arterial hypertension (AH) during pregnancy. Materials The study included 312 pregnant women with hypertension (group I), with an average age of 32 [28–36] years. The diagnosis of moderate and severe hypertension was established before pregnancy on the basis of the national guidelines. The control group consisted of 358 pregnant women without hypertension (group II), with an average age of 28 [24–32] years. The study included the assessment of anthropometric data at 6–8 weeks of pregnancy, questionnaires and assessment of the smoking status of pregnant women (pack-years), ambulatory blood pressure monitoring (ABPM). Results At admission, the mean systolic blood pressure (SBP) in group I was 147 [140–164] mmHg, and the diastolic blood pressure (DBP) was 95.8 [84–100] mmHg. According to the ABPM data, the mean SBP was 142 [135–164] mmHg, and the mean DBP was 95.8 [84–98] mmHg When registered for pregnancy in the group 1, the BMI was significantly higher compared to the control group, 30.2 (25–34,9) and 22.3 (20.2–25.6), p<0.001, respectively. Obesity and smoking were statistically more common in group I compared to the control group, p<0.001 and p=0.01, respectively. The index of the smoker in the group with AH was 7.5 [2.5–15] pack-years, in the control group – 1.9 [1.0–7.5], p<0.001. Smoking pack-years ≥10, increased the chance of developing hypertension by 13.1 (5.5–29.9) times, in turn, with pack-years <10 (compared to non-smokers), the chance of developing hypertension increased by 2.6 (1.6–3.9) times. Obesity significantly increased the chance of hypertension, Odds Ratio=12 (7.6–19.1). Among women with a normal BMI, smoking increased the chance of developing hypertension by 5 (2.7–9.3) times compared to its absence. The combination of smoking and an above-normal BMI compared to no smoking and a normal BMI increased the chance of developing hypertension by 31 (15.3–62) times. In women with a normal BMI, smoking (pack-years <10) increased the chance of developing hypertension by 3.6 (1.8–6.8) times compared to its absence. Also in this group, smoking (pack-years ≥10) increased the chance of developing hypertension by 5 (1.2–21) times compared to IPL<10 and by 17.7 (4.7–67) times compared to no smoking. In women with normal BMI, smoking (pack-years <10), compared with non-smoking women, did not significantly affect the chance of developing hypertension. In obese women, pack-years did not significantly affect the chance of developing hypertension (p=0.07). Conclusions An increase in body mass index and smoking, either single or in combination, can increase the chance of developing hypertension. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Russian Medical Academy of Continuous Professional Education, Novokuznetsk