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Long-Term Risk to Develop Hypertension in Women With Former Preeclampsia: A Longitudinal Pilot Study

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Abstract

Introduction

Women with former preeclampsia (exPE) develop chronic hypertension 4 times more often than healthy parous controls. Women, destined to develop remote chronic hypertension, had increased left ventricular mass index (LVMI) and diastolic blood pressure (BP) prior to the onset of hypertension as compared to those remaining normotensive. However, longitudinal data on the progress of this increased LVMI in women destined to develop hypertension are lacking.

Methods

We included 20 women with exPE and 8 parous controls. At both 1- and 14-year postpartum (pp), we performed cardiac ultrasound and determined circulating levels of the metabolic syndrome variables. Of 14-year pp, 7 (35%) former patients had developed chronic hypertension. We compared these 7 former patients with both the 13 former patients who remained normotensive and the 8 parous controls using the Mann-Whitney U test and Kruskal-Wallis analysis.

Results

Women with hypertensive exPE differed from their normotensive counterparts by a higher incidence of early-onset preeclampsia (PE) in their index pregnancy and a higher rate of recurrence in next pregnancies. At 1-year pp, they also had high/normal BP and higher fasting insulin levels. At 14 years pp, the relative left ventricular wall thickness was higher, and the E/A ratio was lower, in the hypertensive group relative to those remaining normotensive.

Conclusion

Women with exPE are at increased risk of developing chronic hypertension, when (1) the PE in the index pregnancy had an early-onset and/or recurred in next pregnancies and (2) the 1-year pp. Blood pressure was high normal. We also noticed that at 14 years pp, the hypertensive group showed signs of concentric left ventricular remodeling along with a decreased E/A ratio.

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Authors and Affiliations

  1. Department of Obstetrics & Gynecology, Maastricht University Medical Center, Maastricht, the Netherlands

    Chahinda Ghossein-Doha MD, Marc Spaanderman MD, PhD & Sander M. J. van Kuijk MSc

  2. Department of Biomedical Engineering, Maastricht University, Maastricht, the Netherlands

    Chahinda Ghossein-Doha MD & Tammo Delhaas MD, PhD

  3. Department of Epidemiology, Maastricht University, Maastricht, the Netherlands

    Sander M. J. van Kuijk MSc

  4. Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands

    Abraham A. Kroon MD, PhD

  5. Division “Vrouw & Baby”, University Medical Center Utrecht, Utrecht, the Netherlands

    Louis Peeters MD, PhD

  6. Department of Obstetrics and Gynecology, Faculty of Health, Medicine, and Life Sciences, Maastricht University Medical Centre, Maastricht University, PO Box 616, Maastricht, 6200 MD, the Netherlands

    Chahinda Ghossein-Doha MD

Authors
  1. Chahinda Ghossein-Doha MD
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  2. Marc Spaanderman MD, PhD
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  3. Sander M. J. van Kuijk MSc
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  4. Abraham A. Kroon MD, PhD
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  5. Tammo Delhaas MD, PhD
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  6. Louis Peeters MD, PhD
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Corresponding author

Correspondence to Chahinda Ghossein-Doha MD.

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Ghossein-Doha, C., Spaanderman, M., van Kuijk, S.M.J. et al. Long-Term Risk to Develop Hypertension in Women With Former Preeclampsia: A Longitudinal Pilot Study. Reprod. Sci. 21, 846–853 (2014). https://doi.org/10.1177/1933719113518989

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  • DOI: https://doi.org/10.1177/1933719113518989

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