Abstract P164: Blood Pressure During Pregnancy and Risk of Hypertension Later in Life: A Longitudinal Study of POUCHMoms
Objectives: Hypertensive disorders in pregnancy carry a long-term risk of cardiovascular disease (CVD) for women. However, future hypertension status among pregnant women who have moderately elevated blood pressure (MEBP), that does not meet criteria for hypertensive disorders is unknown. We, therefore, investigated the risk of later hypertension among women with MEBP in pregnancy in addition to those diagnosed with gestational hypertensive disorders.
Methods: Data are from the Pregnancy Outcomes and Community Health (POUCH) study, which enrolled pregnant women from 52 clinics in 5 Michigan Communities (1998-2004). We included 667 women with abstracted gestational BP measurements who also participated in the POUCHMoms follow-up 7-15 years later. MEBP was defined as systolic BP (SBP) ≥120mmHg or diastolic BP (DBP) ≥80mmHg among pregnant women who did not have a hypertensive disorder. Hypertensive disorders were defined as at least two SBP measurements ≥140 or DBP measurements ≥90 or regular use of anti-hypertensives, with or without proteinuria. Weighted multinomial logistic regression models were run to estimate the odds of prehypertension or hypertension at follow-up, before and after controlling for maternal prenatal confounders (e.g. age, parity, race) and time between pregnancy and follow-up.
Results: The majority of participants (59.6%) met the criteria for MEBP which was significantly associated with hypertension at follow-up before and after adjustment for confounders (AOR=2.76; 95% CI 1.40, 5.46). Significant associations were seen for MEBP first identified prior to 20 weeks, and for MEBP observed due to elevated SBP either alone or in conjunction with elevated DBP. As expected, gestational hypertensive disorders also were associated with increased odds of hypertension at follow-up (AOR=16.99; 95% CI 6.11, 47.24). All of the above relationships held when body mass index (BMI) at follow-up was added into the models.
Conclusions: Moderately elevated blood pressure in pregnancy may be a risk factor for hypertensive disorders later in life and may identify a group of women who need closer surveillance for CVD risk in the years following pregnancy. Elevated SBP appears to play a more influential role than DBP in the observed association.
Author Disclosures: G. Levi Dunietz: None. K.L. Strutz: None. C.B. Holzman: None. Y. Tian: None. D. Todem: None. B.L. Bullen: None. J.M. Catov: None.
- © 2015 by American Heart Association, Inc.