Prior Preeclampsia Boosts Hypertension Risk


NEW ORLEANS – Women who had early preeclampsia while pregnant faced a threefold increased risk for hypertension 10 years following the affected pregnancy, according to a Dutch study.

But the women showed no significantly increased risk for diabetes, hypercholesterolemia, or metabolic syndrome, Dr. José T. Drost said at the meeting.

This study showed a “very striking, pretty dramatic” difference in the prevalence of hypertension after 10 years, at 44% among women with preeclampsia compared with 17% in women who did not have preeclampsia, said Dr. Glenn A. Hirsch, a cardiologist and director of cardiac rehabilitation at Johns Hopkins Bayview Medical Center, Baltimore.

“Metabolic syndrome may be part of the underlying causal pathway, as waist/hip ratio was increased at baseline in the women with preeclampsia,” Dr. Hirsch said.

The Preeclampsia Risk Evaluation in Females (PREVFEM) study was a 10-year follow-up evaluation of 339 women who developed early preeclampsia while treated at the Isala Clinics during 1991-2005, and 332 matched control women who were pregnant at the same time but did not develop preeclampsia. Dr. Drost and her associates defined early preeclampsia as new-onset hypertension, with a blood pressure of at least 140/90 mm Hg, plus new-onset proteinuria, at a level of at least 0.3 g/24 hr, that first appeared after the 20th gestational week but before the 32nd gestational week.

At the time of the index pregnancy, the age of the women with preeclampsia averaged 30 years, while the controls' average age was 29 years. The index pregnancy was the first pregnancy for 80% of the women with preeclampsia and for 70% of the controls, said Dr. Drost, a researcher in the cardiology department at the Isala Clinics in Zwolle, the Netherlands.

At a screening examination performed a mean of 9-11 years following the index pregnancy, the average blood pressure of the women who had preeclampsia was 127/86 mm Hg, compared with an average of 119/79 in the controls. The prevalence of hypertension was 44% in the women with a history of preeclampsia and 17% in the controls. Women in both groups had a similar average BMI, 29.9 and 26.2 kg/m

In a multivariate analysis that controlled for differences in age, years following pregnancy, and waist circumference, the women with a history of preeclampsia had a significant, 3.3-fold increased risk for hypertension at their follow-up screening examination, compared with the control women, Dr. Drost reported. The prevalence of diabetes and hypercholesterolemia was similar in the two groups at follow-up.

However, the prevalence of metabolic syndrome at follow-up reached 18% in the women who had preeclampsia and 9% in the control women. After adjustment, this represented a 60% increased risk for metabolic syndrome in the women with a history of preeclampsia that fell short of statistical significance.

Dr. Drost had no disclosures.

Hypertension was seen in 44% of women with a history of preeclampsia and 17% of controls 9–11 years later.

Source DR. DROST

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