Chahinda Ghossein-Doha1, Marc Spaanderman2, Sander M J van Kuijk3, Abraham A Kroon4, Tammo Delhaas5, Louis Peeters6. 1. Department of Obstetrics & Gynecology, Maastricht University Medical Center, Maastricht, the Netherlands Department of Biomedical Engineering, Maastricht University, Maastricht, the Netherlands c.ghossein@maastrichtuniversity.nl. 2. Department of Obstetrics & Gynecology, Maastricht University Medical Center, Maastricht, the Netherlands. 3. Department of Obstetrics & Gynecology, Maastricht University Medical Center, Maastricht, the Netherlands Department of Epidemiology, Maastricht University, Maastricht, the Netherlands. 4. Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands. 5. Department of Biomedical Engineering, Maastricht University, Maastricht, the Netherlands. 6. Division "Vrouw & Baby", University Medical Center Utrecht, Utrecht, the Netherlands.
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.
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.
Authors: M E Spaanderman; E Van Beek; T H Ekhart; J Van Eyck; E C Cheriex; P W De Leeuw; L L Peeters Journal: Am J Obstet Gynecol Date: 2000-05 Impact factor: 8.661
Authors: G de Simone; S R Daniels; R B Devereux; R A Meyer; M J Roman; O de Divitiis; M H Alderman Journal: J Am Coll Cardiol Date: 1992-11-01 Impact factor: 24.094
Authors: Chahinda Ghossein-Doha; Louis Peeters; Sanne van Heijster; Sander van Kuijk; Julia Spaan; Tammo Delhaas; Marc Spaanderman Journal: Hypertension Date: 2013-06-03 Impact factor: 10.190
Authors: Gerard H A Visser; Paul H C Eilers; Patty M Elferink-Stinkens; Hans M W M Merkus; Jan M Wit Journal: Early Hum Dev Date: 2009-11-13 Impact factor: 2.079
Authors: Jill N Barnes; Ronée E Harvey; Kathleen B Miller; Muthuvel Jayachandran; Katherine R Malterer; Brian D Lahr; Kent R Bailey; Michael J Joyner; Virginia M Miller Journal: Hypertension Date: 2017-11-20 Impact factor: 10.190
Authors: L Brouwers; A J van der Meiden-van Roest; C Savelkoul; T E Vogelvang; A T Lely; A Franx; B B van Rijn Journal: BJOG Date: 2018-08-10 Impact factor: 6.531
Authors: Fergus P McCarthy; Jamie M O'Driscoll; Paul T Seed; Anna Placzek; Carolyn Gill; Jenie Sparkes; Lucilla Poston; Mike Marber; Andrew H Shennan; Basky Thilaganathan; Paul Leeson; Lucy C Chappell Journal: Hypertension Date: 2021-08-30 Impact factor: 10.190
Authors: Tobias F S Pustjens; Nousjka P A Vranken; Gwyneth Jansen; Patty J C Winkler; Mera Stein; Loes Hoebers; Bas Kietselaer; Marc E A Spaanderman; Saman Rasoul; Chahinda Ghossein-Doha; Arnoud W J van 't Hof Journal: Front Cardiovasc Med Date: 2022-07-15
Authors: T Katrien J Groenhof; Bas B van Rijn; Arie Franx; Jeanine E Roeters van Lennep; Michiel L Bots; A Titia Lely Journal: Eur J Prev Cardiol Date: 2017-09-12 Impact factor: 7.804