Increased left ventricular mass index (HR 1.08; 95% CI 1.01-1.16) and diastolic blood pressure independently predicted later chronic hypertension in normotensive women with prior preeclampsia.
Cohort (n=349)
Do increased measures of cardiac geometry and decreased cardiac function at postpartum screening predict the development of chronic hypertension in normotensive women with a history of preeclampsia?
In normotensive women with a history of preeclampsia, increased left ventricular mass index and diastolic blood pressure at postpartum screening independently predict the future development of chronic hypertension.
Effect estimate: HR 1.08 (95% CI 1.01-1.16)
Preeclampsia is associated with a 4-fold higher risk for developing remote chronic hypertension. Preeclampsia is accompanied by left ventricular hypertrophy and decreased diastolic function, which may or may not resolve postpartum. We tested the hypothesis that increased measures of cardiac geometry and decreased cardiac function persisting for ≥ 6 months postpartum in normotensive women with a history of preeclampsia precede the development of later chronic hypertension. Formerly preeclamptic women (n=652) underwent echocardiography at 9 months (range, 6-19) postpartum. We excluded women with preexisting hypertension (n=42), hypertension at the postpartum screening (n=133), and those that did not return any checklist (n=128). Eventually, 349 women were included. Remote health was evaluated by a biennially checklist. We used Cox regression for analysis. Twenty-seven (8%) normotensive women had developed chronic hypertension during a medium follow-up period of 6 years. At screening they differed from their counterparts who remained normotensive by hazard ratio for left ventricular mass index (1.11; 95% confidence interval CI, 1.03-1.18), diastolic blood pressure (1.13; 95% CI, 1.06-1.20), systolic blood pressure (1.07; 95% CI, 1.02-1.11), mean arterial pressure (1.11; 95% CI, 1.05-1.18), heart rate (1.05; 95% CI, 1.01-1.10), and E/A ratio (0.22; 95% CI, 0.06-0.85). Backward stepwise analysis showed independent hazard ratio for left ventricular mass index and diastolic blood pressure 1.08 (95% CI, 1.01-1.16) and 1.13 (95% CI, 1.06-1.21), respectively. In conclusion, the development of later chronic hypertension in initially normotensive formerly preeclamptic women is preceded by increased left ventricular mass index and diastolic blood pressure at postpartum screening.
Ghossein‐Doha et al. (Tue,) conducted a cohort in History of preeclampsia (n=349). Increased left ventricular mass index and diastolic blood pressure vs. Lower left ventricular mass index and diastolic blood pressure was evaluated on Development of chronic hypertension (HR 1.08, 95% CI 1.01-1.16). Increased left ventricular mass index (HR 1.08; 95% CI 1.01-1.16) and diastolic blood pressure independently predicted later chronic hypertension in normotensive women with prior preeclampsia.