HDP history plus hypertension in women tied to LV remodeling later in life

Women with a history of hypertensive disorders of pregnancy (HDP) and current hypertension may present with marked differences in left ventricular structure and functions a decade after pregnancy, suggests a recent study, noting the importance of continued surveillance and targeted therapies for the prevention of cardiovascular disease.

The investigators selected 132 women with pregnancies delivered from 2008 to 2009 from a clinical cohort with abstracted pregnancy and placental pathology data to undergo transthoracic echocardiography (2017 to 2020). They measured the participants’ medical history, blood pressure, and weight at the study visit.

Of the enrolled women (mean age, 38±6 years; 10±1 years postdelivery), 102 had normotensive pregnancies and 30 had HDP (pre-eclampsia, n=21; gestational hypertension, n=9). Women with HDP history, relative to those with normotensive pregnancies, were at greater risk of developing current hypertension (63 percent vs 26 percent; p<0.001).

Women with HDP history also had higher interventricular septal thickness (β, 0.08; p=0.04) and relative wall thickness (β, 0.04; p=0.04) after adjusting for age, race, maternal vascular malperfusion (MVM) lesions, body mass index, current hypertension, and haemoglobin A1c.

Subgroup analyses revealed a higher proportion of left ventricular remodeling among those with both HDP history and current hypertension (79.0 percent) than all other groups (only HDP: 36.4 percent; p=0.01; only current hypertension: 46.2 percent; p=0.02; neither HDP nor hypertension: 38.2 percent; p<0.001), as well as lower mitral inflow E/A and annular e’.

Accounting for placental MVM lesions did not affect the results.