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Association of Hypertensive Disorders of Pregnancy With Left Ventricular Remodeling Later in Life

Journal of the American College of Cardiology, 2021-03, Vol.77 (8), p.1057-1068 [Peer Reviewed Journal]

Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2020.12.051 ;PMID: 33632480

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  • Title:
    Association of Hypertensive Disorders of Pregnancy With Left Ventricular Remodeling Later in Life
  • Author: Countouris, Malamo E ; Villanueva, Flordeliza S ; Berlacher, Kathryn L ; Cavalcante, João L ; Parks, W Tony ; Catov, Janet M
  • Is Part Of: Journal of the American College of Cardiology, 2021-03, Vol.77 (8), p.1057-1068
  • Description: Hypertensive disorders of pregnancy (HDP) are associated with short-term cardiac structure and function abnormalities, but later life changes are not well studied. This study aimed to determine if HDP history is associated with echocardiographic differences 8 to 10 years after delivery, and if subgroups with placental maternal vascular malperfusion (MVM) lesions or current hypertension may be particularly affected. Women with pregnancies delivered from 2008 to 2009 were selected from a clinical cohort with abstracted pregnancy and placental pathology data to undergo transthoracic echocardiography (2017 to 2020). Medical history, blood pressure, and weight were measured at the study visit. The authors enrolled 132 women (10 ± 1 years post-delivery, age 38 ± 6 years): 102 with normotensive pregnancies and 30 with HDP: pre-eclampsia (n = 21) or gestational hypertension (n = 9). Compared with women with normotensive pregnancies, those with HDP history were more likely to have current hypertension (63% vs. 26%; p < 0.001). After adjusting for age, race, MVM lesions, body mass index, current hypertension, and hemoglobin A1c, women with HDP history had higher interventricular septal thickness (β = 0.08; p = 0.04) and relative wall thickness (β = 0.04; p = 0.04). In subgroup analyses, those with both HDP history and current hypertension had a higher proportion of left ventricular remodeling (79.0%) compared with all other groups (only HDP [36.4%; p = 0.01], only current hypertension [46.2%; p = 0.02], and neither HDP nor hypertension [38.2%; p < 0.001]), and lower mitral inflow E/A and annular e'. Accounting for placental MVM lesions did not impact results. Women with both HDP history and current hypertension have pronounced differences in left ventricular structure and function a decade after pregnancy, warranting continued surveillance and targeted therapies for cardiovascular disease prevention.
  • Publisher: United States
  • Language: English
  • Identifier: ISSN: 0735-1097
    EISSN: 1558-3597
    DOI: 10.1016/j.jacc.2020.12.051
    PMID: 33632480
  • Source: Geneva Foundation Free Medical Journals at publisher websites
    Alma/SFX Local Collection
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