arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2025-2493MRUSXFarthyper-2493Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESАртериальная гипертензия белого халата у беременных: клиническая характеристика, структурно‑функциональное состояние сердца, сосудов и почекWhite coat hypertension in pregnant women: clinical characteristics, changes in the heart, kidney, and blood vesselshttps://orcid.org/0000-0003-4958-4695НиколенкоЕ. С.NikolenkoE. S.

Николенко Екатерина Сергеевна — ассистент кафедры факультетской терапии

Ekaterina S. Nikolenko, MD, Assistant Professor, Department of Therapy

nikolenkokate@yandex.ruhttps://orcid.org/0000-0002-0952-6856ЧулковВ. С.ChulkovV. S.

Чулков Василий Сергеевич — доктор медицинских наук, профессор кафедры внутренних болезней 

Vasiliy S. Chulkov, MD, PhD, DSc, Professor, Department of Internal Diseases

vschulkov@rambler.ruhttps://orcid.org/0000-0002-1948-8523ЧулковВл. С.ChulkovVl. S.

Чулков Владислав Сергеевич — кандидат медицинских наук, доцент кафедры факультетской терапии

Vladislav S. Chulkov, MD, PhD, Associate Professor, Department of Therapy

vlad.chulkov.1989@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Южно-Уральский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияSouth Ural State Medical UniversityRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Новгородский государственный университет имени Ярослава Мудрого»РоссияYaroslav-the-Wise Novgorod State UniversityRussian Federation202514112025314289300Copyright © Николенко Е.С., Чулков В.С., Чулков В.С., 20252025Николенко Е.С., Чулков В.С., Чулков В.С.Nikolenko E.S., Chulkov V.S., Chulkov V.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2493

Актуальность. Беременность характеризуется адаптационными изменениями в сердце, сосудах и почках, которые необходимы для удовлетворения возросших гемодинамических потребностей плода, обеспечивая при этом гомеостаз у матери. В настоящее время отсутствуют сведения об адаптационных изменениях сердечно-сосудистой системы и почек у беременных с артериальной гипертензией (АГ) белого халата. Цель исследования — сравнить частоту факторов кардиометаболического риска, структурнофункциональное состояние сердца, сосудов и почек у беременных с АГ белого халата и у беременных с нормальным артериальным давлением (АД). Материалы и методы. В исследование включены 88 беременных, разделенных на две группы. Группа 1 (основная) — 44 женщины с АГ белого халата (возраст 32,5 ± 5,7 года); группа 2 (группа сравнения) — 44 женщины с нормальным АД (возраст 28,1 ± 5,9 года), р = 0,001. Проводилась оценка клинических факторов, показателей суточного мониторирования АД, структурно-функциональная оценка сердца, почек и сосудов. Результаты. У беременных с АГ белого халата чаще встречались абдоминальное ожирение и преэклампсия в анамнезе; суточный профиль АД сопровождался более высокими показателями систолического АД (САД) и диастолического АД (ДАД) днем и ночью, вариабельности САД днем, у них отмечались более высокие индекс времени САД днем, индекс времени ДАД днем и ночью, средняя частота сердечных сокращений днем, чаще регистрировались профиль “non-dipper”; изменения сердца, сосудов и почек характеризовались ранними признаками ремоделирования сердца и сосудов в сочетании с начальными функциональными изменениями почек в сравнении с беременными с нормальным АД. Заключение. Беременные с АГ белого халата требуют тщательного наблюдения с оценкой факторов кардиометаболического риска, проведением суточного мониторинга АД до 20 недель беременности и комплексной оценкой структурно-функционального состояния органов-мишеней с целью дифференциального диагноза с хронической АГ и прогнозом риска ее развития. 

Background. Pregnancy is characterized by adaptive changes in the heart, blood vessels and kidneys, which are necessary to meet the increased hemodynamic needs of the fetus, while ensuring mother’s homeostasis. Currently, there is no information about adaptive changes in the cardiovascular system and kidneys in pregnant women with white coat hypertension. Objective. To compare the frequency of cardiometabolic risk factors, changes in the heart, kidney, and blood vessels in pregnant women with white coat hypertension and in pregnant women with normal blood pressure (BP). Design and methods. The study included 88 pregnant women divided into two groups: group 1 (main group) — 44 women with white coat hypertension (aged 32,5 ± 5,7 years) and group 2 (comparison group) — 44 women with normal blood pressure (aged 28,1 ± 5,9 years), p = 0,001. The assessment of clinical factors, 24-hour BP monitoring parameters, structural and functional assessment of the heart, kidneys and blood vessels was carried out. Results. Pregnant women with white coat hypertension had a higher incidence of abdominal obesity and preeclampsia in the previous pregnancy; based on the 24-hour BP monitoring they had higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) during the day and at night, higher SBP variability during the day, higher SBP time index during the day, higher DBP time index during the day and night, higher average heart rate during the day, higher rate of non-dipper profile. They also demonstrated early signs of heart and vessel remodeling accompanied by the initial functional changes in the kidneys compared with pregnant women with normal BP. Conclusion. Pregnant women with white coat hypertension require careful monitoring and assessment of cardiometabolic risk factors, daily BP monitoring till 20 weeks of pregnancy, and a comprehensive assessment of the structural and functional state of target organs in order to make a differential diagnosis with chronic arterial hypertension and predict the risk of its development.

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The authors declare that there are no conflicts of interest present.