Abstract P089: Pre-eclampsia and Risk of Subsequent Hypertension: In an American Indian Population
Background and Objectives: Preeclampsia (PE) is a pregnancy-specific disorder that affects 2-8% of all pregnancies and as many as 60,000 annual maternal mortalities globally. A number of proposed pathophysiologic mechanisms relate to similar factors implicated in cardiovascular disease, such as endothelial dysfunction, inflammation, insulin resistance and impaired renal regulation. Pre-eclampsia has been associated with subsequent hypertension, cardiovascular disease and related mortality in later life.
Methods: The 3 most recent blood pressures, body mass index (BMI) and use of hypertensive medications were recorded from electronic medical records of routine clinic visits for 130 cases and 289 controls previously identified and carefully characterized for a study of the etiology and complications of PE. Comparison between case and control groups was made using the student t test for continuous variables and chi-square testing for discrete variables. Linear regression analysis was used to evaluate the effects of risk factors on subsequent systolic and diastolic blood pressure (SBP and DBP respectively).
Results: Follow-up measurements occurred a mean of 13.11 years (range 3.6 to 36.7 years) post PE pregnancy. Cases were of similar age (35.9 vs 36.1 years, p=0.82); but with significantly higher BMI (34.1 vs 31.6, p<0.002), systolic (127.2 vs 121.3 mm Hg, p<0.001 and diastolic (76.2 vs 72.6 mm Hg, p<0.001) blood pressure, and more likely to be using hypertensive medications (35/130, 27% vs 25/289, 9%, p<0.001). Linear regression showed significant and independent association between BMI (SBP β=0.47, DBP β=0.29), age (SBP β=0.19, DBP β=0.14), previous history of PE (SBP β=4.47, DBP β=2.71) and current systolic and diastolic blood pressure (all p values <0.002). Analysis of the quartile with follow-up of less than 7.19 years also shows independent association of prior PE with both SBP (β=6.54, p<0.006) and DBP (β=4.96, p<0.001).
Discussion and Conclusions: PE appears to confer risk of subsequent hypertension on American Indian women after a period of at least 13 years. This risk is independent of additional risk factors such as increased BMI and age. The risk is apparent soon after the affected pregnancy and there are undoubtedly cases where the hypertension of PE fails to resolve post partum.
Author Disclosures: L.G. Best: None. L. Lunday: None. E. Webster: None. J.R. Beal: None.
- © 2016 by American Heart Association, Inc.