Aleksandra IlicUniversity of Novi Sad, Faculty of Medicine, Serbia
Title: The Importance of Ambulatory Blood Pressure Monitoring in the Diagnosis of Hypertensive Disorders of Pregnancy and Non-Dipping Pattern of Blood Pressure in Gestational Hypertension
It is well known that non-dipping pattern of blood pressure is a significant risk factor for adverse cardiac and cerebrovascular events.
An ambulatory blood pressure monitoring (ABPM) provides the most accurate and reliable assessment of the day-night pattern of blood pressure. It is necessary for the detection of “white coat hypertension” and to monitor the effect of antihypertensive therapy. It also takes an important role for the diagnosis of hypertension in pregnancy.
Gestational hypertension (GH) is one of the entities of the hypertensive disorders of pregnancy (HDP), and it is among the leading causes of maternal, fetal, and neonatal morbidity and mortality. As well, the HDP have been recognized as an important risk factor for cardiovascular diseases. Thus, women who develop GH or preeclampsia are at increased risk of hypertension, ischemic heart disease and stroke later in life.
It has been shown that ABPM had higher accuracy for the prediction of GH, premature childbirth and low birth weight, compared with the conventional blood pressure measurements. In addition, we have found that non-dipping pattern of blood pressure is very highly related with worse pregnancy outcome in a term of preterm delivery and intrauterine growth restriction. Also, it is associated with worse maternal hemodynamics, more impaired systolic function and more pronounced cardiac remodeling compared to women with GH and dipping pattern of blood pressure.
With the aim of the best possible treatment to reduce the potential harm, it is very important to know the contemporary classification and diagnosis of HDP, as well as the pathophysiological changes in maternal hemodynamics caused by gestational hypertension and preeclampsia, especially in relation to the blood pressure pattern.
Aleksandra Ilic has completed her PhD in the field of gestational hypertension in 2015.
Since 2013, she has been the coordinator of the Special Health Program, supported by the Provincial Secretariat for Health of the Government of the Autonomous Province of Vojvodina, entitled "Early detection of changes in function and remodeling of the left ventricle and circadian rhythm of blood pressure in hypertensive pregnant women". This program was designed with the aim of improving the health of vulnerable populations, such as pregnant women.
She published the results of research in this field in international and national journals and also presented them at European/World Congresses of Cardiology and Echocardiography, as well as at Congresses organized by the International Society for the Study of Hypertension in Pregnancy and The International Congress on Cardiac Problems in Pregnancy. Her research, also from the area of gestational hypertension, was awarded as one of the best in the field of hypertension at the ESC Congress 2017.
She is an assistant professor at the Faculty of Medicine, University of Novi Sad.
From 2015 to 2019, she was the head of the Echocardiography and Functional Cardiac Diagnostics Department. Since 2019, she is the deputy manager of the Department of Cardiology, Institute of Cardiovascular Diseases of Vojvodina.
She is the vice-president of the Serbian Society of Cardiology and past-president of Working Group on Cardiovascular Imaging of the Serbian Society of Cardiology from 2019-2021.