To identify metabolic and obstetric risk factors associated with hypertension after preeclampsia.
Obstetrics and Gynecology, 07/31/2012
Spaan, Julia J et al. – Several metabolic and obstetric risk factors related to hypertension postpartum in the short term and predisposed to the subsequent development of chronic hypertension after preeclampsia in initially normotensive women.Methods
- The authors analyzed demographic and clinical data from a postpartum screening (blood pressure, microalbuminuria and fasting plasma levels of glucose, insulin, and lipid profile) from 683 primiparous women with a history of preeclampsia.
- Excluded women with pre–existing hypertension, kidney disease, or diabetes mellitus.
- In the group of women who were normotensive at postpartum screening, authors evaluated the risk of developing chronic hypertension in the years after screening using questionnaires.
- Hypertension at postpartum screening was related to obesity, elevated fasting levels of insulin, low–density lipoprotein, microalbuminuria, family history of hypertension, and delivery before 34 weeks of gestation .
- Authors identified 27 cases of hypertension within 2,095 person–years during a median 6–year follow–up in the group of women normotensive at postpartum screening.
- The hazard rate for the development of hypertension was 2.9 and 8.1 respectively, when two and three or more components of the metabolic syndrome were present; 3.7 for family history of hypertension; and 4.3 for recurrence of a hypertensive disorder in pregnancy.