J Am Coll Cardiol: If you have hypertension during pregnancy, you must be alert to cardiovascular disease for your whole life!

Introduction: If you have hypertension during pregnancy, you must be alert to cardiovascular disease for your whole life! Hypertension in pregnancy (HDP) is related to short-term cardiac structure and function abnormalities, but there are few studies on the effects of HDP on the cardiovascular structure and function of pregnant women in the later stages.

The purpose of this study was to explore the correlation between the HDP history and the differences in echocardiographic findings 8-10 years postpartum, and whether the subgroups of placental maternal vascular perfusion (MVM) lesions or current hypertension will be particularly affected.

The researchers selected women who gave birth in 2008-2009 from the clinical cohort of pregnancy and placental pathology data for transthoracic echocardiography (2017-2020).

Check medical history, measure blood pressure and weight during research visits.

A total of 132 women were recruited (10±1 years postpartum, age 38±6 years): 102 normal pregnancies, 30 HDP: preeclampsia (n=21) or hypertension during pregnancy (n=9).

Compared with pregnant women with normal blood pressure, women with a history of hypertension are more likely to have high blood pressure (63% vs 26%; P<0.
001).

After adjusting for age, race, MVM lesions, body mass index, hypertension, and hemoglobin A1c, women with a history of hypertension had ventricular septal thickness (β=0.
08; P=0.
04) and relative ventricular septal thickness (β=0.
04; P =0.
04) are all higher.

In the subgroup analysis, the proportion of left ventricular remodeling (79.
0%) of patients with both HDP history and current hypertension was significantly higher than that of all other groups (only HDP group 36.
4%, P=0.
01; only current hypertension) 46.
2% in the group, P=0.
02; 38.
2% in the group with neither HDP history nor hypertension, P<0.
001]).

The inclusion of placental MVM lesions in the analysis did not affect the results.

In summary, women with a history of HDP and hypertension have significant differences in left ventricular structure and function after 10 years of pregnancy, suggesting that such women need continuous monitoring and targeted treatment to prevent cardiovascular disease .

Original source: Countouris Malamo E, Villanueva Flordeliza S, Berlacher Kathryn L et al.
Association of Hypertensive Disorders of Pregnancy With Left Ventricular Remodeling Later in Life.
J Am Coll Cardiol, 2021, 77: 1057-1068.