A prediction model combining clinical and echocardiographic features accurately identified women with persistent hypertension after hypertensive disorders of pregnancy (AUC 0.85; 95% CI 0.79-0.90).
Cohort (n=211)
Does peripartum screening with clinical and echocardiographic features predict chronic hypertension in women with hypertensive disorders of pregnancy?
A peripartum screening model combining clinical and echocardiographic features accurately predicts the development of chronic hypertension in women with hypertensive disorders of pregnancy.
Effect estimate: AUC 0.85 (95% CI 0.79-0.90)
BACKGROUND Chronic hypertension (CHT) is the main risk factor for cardiovascular diseases in women with a history of hypertensive disorders of pregnancy (HDP). OBJECTIVES This study sought to assess the effectiveness of peripartum screening in predicting CHT after HDP. METHODS In this longitudinal prospective study, women with HDP underwent peripartum transthoracic echocardiography and were evaluated for CHT (blood pressure ≥140/90 mm Hg or on antihypertensive medication) at least 3 months postpartum. Univariable and multivariable analyses assessed the association between clinical and transthoracic echocardiography data and a postpartum diagnosis of CHT. RESULTS At a median postpartum follow-up of 124 days (IQR: 103-145 days), 70 (33.2%) of 211 women remained hypertensive. Compared with normotensive women, women with CHT were older (35.5 ± 5.0 years vs 32.9 ± 5.6 years; P = 0.001), were more likely to be Afro-Caribbean (27.1% vs 7.8%; P 75 g/m2, relative wall thickness >0.42, and E/e' ratio >7) showed excellent accuracy in identifying women with persistent hypertension after HDP (area under the curve: 0.85; 95% CI: 0.79-0.90). CONCLUSIONS This peripartum screening approach might be used to identify women at risk of CHT who would benefit from intensive blood pressure monitoring and pharmacological strategies from the early postpartum period to prevent cardiovascular disease.
Giorgione et al. (Sat,) conducted a cohort in Hypertensive disorders of pregnancy (n=211). Prediction model combining clinical and echocardiographic features was evaluated on Persistent hypertension (chronic hypertension) after HDP (AUC 0.85, 95% CI 0.79-0.90). A prediction model combining clinical and echocardiographic features accurately identified women with persistent hypertension after hypertensive disorders of pregnancy (AUC 0.85; 95% CI 0.79-0.90).
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