Women with past hypertensive pregnancy at greater cardiovascular risk

Blood pressure values and ventricular mass tend to be more elevated among women with previous de novo pre-eclampsia (PE) than those with previous normal pregnancies, according to a study.

However, “the most significant cardiovascular repercussions were observed in women with previous superimposed PE or CH during pregnancy,” the authors said.

Women with 2–5 years of previous pregnancies were included in this cross-sectional study conducted at a tertiary hospital. Eligible participants were divided into three groups: isolated PE (de novo PE: n=30), superimposed PE and/or chronic hypertension (PEs/HC: n=60), and normal gestation (NG: n=30).

The authors assessed age, BMI, office systolic (SBP) and diastolic blood pressure (DBP), 24-h ambulatory blood pressure monitoring (ABPM), noninvasive central blood pressure (CBP) by tonometry (sphygmocor), pulse wave velocity (PWV), and echocardiography.

Women with PEs/HC tended to be older (mean age 38 years) and have greater weight (mean BMI 32.6 kg/m²). The de novo PE and PEs/HC cohorts showed higher office SBP than the NG cohort (124.8 and 133.6 vs 114.6 mm Hg), while the PEs/HC group had higher DBP than the NG and de novo PE groups (87.8 vs 73.3 and 80.4 mm Hg).

ABPM revealed higher SBP in all periods among women with PEs/HC than those with NG or de novo PE. Central SBP was higher in the PEs/HC and de novo PE cohorts than the NG cohort, while carotid-femoral PWV was higher in PEs/HC than in NG and de novo PE (8.1 vs 6.8 and 7.0 m/s).

Results of echocardiography bared greater septal thickness and left atrial diameter in PEs/HC, with a higher left ventricular mass index in de novo PE and PEs/HC than NG.