Cardiovascular responses to exercise following adolescent hypertensive pregnancy

With the establishment of hypertension as a risk factor for the development of coronary artery disease, more attention is being given to hypertension in youth. Hypertension during pregnancy has been associated with an increased incidence of hypertension in later years. To determine if this could be identified early, a group of adolescents who had been hypertensive during pregnancy and a control group who had normotensive pregnancies were studied by stress exercise testing and compared 4--6 years post partum. At rest, during each phase of graded exercise, and during the postexercise observation period, mean heart rate was significantly higher in the previously hypertensive group. Double product (heart rate x blood pressure), an index of myocardial oxygen consumption, was also significantly greater in the previously hypertensive group. When corrected for body weight and race, the amplitude of the R wave in lead V5 as well as a change in R-wave height with exercise were significantly greater in the group of adolescents who had been hypertensive during pregnancy. The observation of group differences 4--6 years post partum suggests a continuing abnormality that may predispose this group to develop early hypertensive cardiovascular disease.