If untreated for a long time, hypertensive conditions during pregnancy may result in Hypertension

Hypertensive Disorders of Pregnancy (HDP) were associated with an increased risk of hypertension 10 years later, according to a prospective cross-sectional study.

HDP, which affects about 20% of pregnant women, is a major cause of morbidity and mortality.

A previous meta-analysis found that a history of HDP was associated with a higher risk of cardiovascular disease compared with no history of HDP. Among patients with a history of HDP, chronic hypertension was seen in 56% compared with 23.5% of those without HDP (adjusted relative risk 2.38, 95% CI 1.40-4.40), reported Lisa Levine, MD, MSCE, of the Hospital of the University of Pennsylvania in Philadelphia, and colleagues.

This risk remained after adjusting for race, maternal age, body mass index, and history of preterm birth, this was noted in the Journal of the American College of Cardiology.

For this study, Levine and colleagues assessed 135 patients (84 with a history of HDP and 51 without); 85% of the patients were Black. Black patients had a higher prevalence of HDP history (92% vs 78% without HDP). There were no significant differences in maternal age, body mass index, tobacco use, and history of gestational diabetes, among others, between those with and without HDP.

In an exploratory analysis, women with chronic hypertension showed more left ventricular remodeling, including the higher intraventricular septum, posterior wall, and relative wall thickness, as well as worse diastolic function, including lower septal I, lateral I, and E/A ratio; more abnormal global longitudinal strain; and higher effective arterial elastance, compared with those without chronic hypertension.

“The importance of studying a more diverse population, including a larger percentage of Black patients, is of critical importance given that both HDP and cardiovascular disease disproportionately affect Black women,” the authors wrote.

A limitation to the study was a lack of data on pre-pregnancy cardiovascular abnormalities, which may have had downstream effects during pregnancy.

Levine and team also noted that the sample size was largely from urban communities; therefore, the results may not be generalizable to other groups.