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Hypertension after preeclampsia is preceded by changes in cardiac structure and function.
Chahinda Ghossein-Doha1, Louis Peeters, Sanne van Heijster
1Department of Obstetrics and Gynecology, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands. c.ghossein@maastrichtuniversity.nl
Hypertension (Dallas, Tex. : 1979)
|June 5, 2013
Summary
Women with a history of preeclampsia who remain normotensive postpartum may still develop chronic hypertension. Persistent cardiac changes like increased left ventricular mass index and diastolic blood pressure at 6 months postpartum predict future hypertension.
Area of Science:
- Cardiology
- Obstetrics
- Hypertension Research
Background:
- Preeclampsia significantly increases the risk of developing chronic hypertension later in life.
- Cardiac changes like left ventricular hypertrophy and diastolic dysfunction can persist postpartum after preeclampsia.
Purpose of the Study:
- To investigate if persistent cardiac geometry and function changes postpartum predict the development of chronic hypertension in women with a history of preeclampsia.
Main Methods:
- Echocardiography was performed on 349 normotensive women with a history of preeclampsia at 9 months postpartum.
- Cox regression analysis was used to evaluate the association between cardiac parameters and the development of chronic hypertension over a 6-year follow-up.
- Cardiac geometry (left ventricular mass index) and function (diastolic blood pressure, E/A ratio) were assessed.
Main Results:
- Eight percent of women developed chronic hypertension during follow-up.
- Increased left ventricular mass index and diastolic blood pressure at postpartum screening were associated with a higher risk of developing chronic hypertension.
- Independent predictors identified were left ventricular mass index (HR 1.08) and diastolic blood pressure (HR 1.13).
Conclusions:
- Persistent cardiac abnormalities, specifically increased left ventricular mass index and elevated diastolic blood pressure, identified at postpartum screening predict the future development of chronic hypertension in women with a history of preeclampsia.
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