Re: Antiphospholipid testing and Systolic BP levels
We thank Dr Charkin for highlighting an ambiguity in the guideline in
terms of levels of systolic blood pressure and apologize for this. Where
diastolic bp is less than 90mmHg, we would recommend that a woman is
referred on the same day if she has a systolic bp of 160mmHg or more, with
or without proteinuria (and no other symptoms).
The PRECOG guideline is not primarily a hypertension guideline and
has not therefore comprehensively addressed all permutations and
combinations of new hypertension. We have rather focused on diastolic
blood pressure, and on the implication of new hypertension in terms of the
development of pre-eclampsia. The two references to systolic blood
pressure levels were added on request, to highlight the potential risk
from systolic blood pressure alone.
References
1. Milne F,Redman C,Walker J,et al.The pre-eclampsia community guideline
(PRECOG): how to screen for and detect onset of pre-eclampsia in the
community.BMJ 2005; 330: 576-580
2. Wilson WA, Gharavi AE, Koike T, Khamastha MA. International consensus
statement on preliminary classification criteria for antiphospholipid
syndrome: Report of an International workshop Arthritis Rheum 1999; 42,
1309-11.
3. Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal
booking: a systematic review of controlled studies. BMJ 2005;330: 565-7.
Competing interests:
None declared
Competing interests:
No competing interests
19 April 2005
Fiona M Milne
Corresponding author on behalf of the PRECOG group
Action on Pre-eclampsia, 84-88 Pinner Rd, Harrow, Middlesex HA1 4HZ
Rapid Response:
Re: Antiphospholipid testing and Systolic BP levels
We thank Dr Charkin for highlighting an ambiguity in the guideline in terms of levels of systolic blood pressure and apologize for this. Where diastolic bp is less than 90mmHg, we would recommend that a woman is referred on the same day if she has a systolic bp of 160mmHg or more, with or without proteinuria (and no other symptoms).
The PRECOG guideline is not primarily a hypertension guideline and has not therefore comprehensively addressed all permutations and combinations of new hypertension. We have rather focused on diastolic blood pressure, and on the implication of new hypertension in terms of the development of pre-eclampsia. The two references to systolic blood pressure levels were added on request, to highlight the potential risk from systolic blood pressure alone.
References
1. Milne F,Redman C,Walker J,et al.The pre-eclampsia community guideline (PRECOG): how to screen for and detect onset of pre-eclampsia in the community.BMJ 2005; 330: 576-580
2. Wilson WA, Gharavi AE, Koike T, Khamastha MA. International consensus statement on preliminary classification criteria for antiphospholipid syndrome: Report of an International workshop Arthritis Rheum 1999; 42, 1309-11.
3. Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: a systematic review of controlled studies. BMJ 2005;330: 565-7.
Competing interests: None declared
Competing interests: No competing interests