(587) Can B-type Natriuretic Peptide (BNP) help differentiate Gestational Hypertension and Preeclampsia from Chronic Hypertension?

Thursday, January 30, 2025

4:00 PM - 6:00 PM

Submitting Author and Presenting Author(s)

Olivia Grubman, MD

MFM Attending
Westchester Medical Center
Westchester, NY, United States

Coauthor(s)

MM

Mackenzie MItchell, BA, MA

Icahn School of Medicine
New York, New York, United States
CC

Christina Cary, MD

Icahn School of Medicine
New York, New York, United States
Mia A. Heiligenstein, MD

Fellow
Mount Sinai West
Astoria, NY, United States
Thomas Owens, MD

Dr Thomas Owens
Icahn School of Medicine at Mount Sinai West
New York, New York, United States
GS

Guillaume Stoffels, MS

Statistician
Icahn School of Medicine at Mount Sinai
New York, New York, United States
ZA

Zainab Al-Ibraheemi, MD

Icahn School of Medicine at Mount Sinai West
New York, New York, United States
DS

Desmond M. Sutton, MD

Director of OB Quality and Patient Safety, Medical Director of Labor and Delivery
Mount Sinai West Hospital
New York, New York, United States
LB

Lois Brustman, MD

Icahn School of Medicine at Mount Sinai West
New York, New York, United States

Objective: B-type natriuretic peptide (BNP) is a cardiac biomarker that is synthesized and secreted from the cardiac ventricles in response to volume expansion and pressure overload. The primary objective was to determine if BNP value could help differentiate gestational hypertension, preeclampsia without severe features and preeclampsia with severe features from chronic hypertension (CHTN). Given the acuity of gestational hypertension (GHTN) and preeclampsia (PEC) versus the chronic nature of preexisting CHTN, we hypothesized that a higher BNP value will be associated with GHTN and PEC compared to CHTN.

Study Design: This was a retrospective cross-sectional study involving 391 patients evaluated for hypertension in pregnancy from January 2022 to February 2023 in an urban teaching hospital. CHTN, GHTN and PEC were defined according to ACOG. Those patients with superimposed preeclampsia were excluded. Demographic characteristics, BNP value, hypertension diagnosis and delivery information were collected for all patients. BNP value was collected on the labor and delivery unit at the time of initial evaluation for hypertensive disease.

Results: The study population consisted of 391 patients. There were 326 patients in the GHTN/PEC group (149 with GHTN, 54 with PEC w/oSF & 123 with PEC w/SF) and 65 in the CHTN group. There was no significant difference in patient demographics between the two groups. The mean BNP level for the GHTN/PEC group was 22.0 pg/mL, whereas the mean BNP level for the CHTN group was 11.2 pg/mL, which was significantly different (p=0.0004) (Figure 1 & Table 1).

Conclusion: This study demonstrates that BNP levels are significantly higher in patients with GHTN/PEC compared to those with CHTN. Therefore, BNP may be a useful test in helping to differentiate between CHTN and GHTN/PEC at the time of initial diagnosis.This is important given the differences in management and delivery implications for each disease.