Incident and related risk factors of hypertension in women with a history of preeclampsia / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the prevalence of hypertension in women with a history of preeclampsia (PE) and to estimate related risk factors.</p><p><b>METHODS</b>In this prospective case-control study, we collected clinical data from 809 women with a history of PE and 3 421 women with normal pregnancy from January 2008 to June 2012. Between November 2012 and April 2013, 651 women in PE group and 2 684 women with normal pregnancy group were recruited at the same time for collecting postpartum data including blood pressure, blood glucose and blood lipid. Binary logistic regression analysis was applied to analyze the relative factors of postpartum blood pressure.</p><p><b>RESULTS</b>Prevalence of hypertension in PE group was higher than those with normal pregnancy (17.2% (112/651) vs. 1.1% (30/2 684), P < 0.01). Prevalence of hypertension in severe PE and mild PE patients was similar (20.1% (58/289) vs. 15.2% (55/362), P = 0.103). Binary logistic regression analysis indicated that progestational body mass index (OR = 1.379, 95% CI 1.257-1.510, P < 0.05) , antepartum systolic blood pressure (OR = 1.025, 95%CI1.012-1.040, P < 0.05) , antepartum triglyceride (OR = 1.002, 95% CI 1.002-1.410, P < 0.05) , antepartum fasting blood glucose (OR = 1.733, 95% CI 1.047-2.870, P < 0.05) , postpartum body mass index (OR = 1.279, 95% CI 1.199-1.363, P < 0.05), postpartum fasting insulin (OR = 1.107, 95% CI 1.055-1.162, P < 0.05) , systolic blood pressure difference between antepartum and postpartum (OR = 1.024, 95% CI1.011-1.037, P < 0.05) , difference on triglyceride value between antepartum and postpartum (OR = 1.26, 95% CI 1.069-1.486, P < 0.01), difference value of HOMA-IR between antepartum and postpartum (OR = 2.448, 95% CI 1.330-4.500, P < 0.01) and difference value of high density lipoprotein cholesterol between antepartum and postpartum (OR = 1.699, 95% CI 1.277-2.260, P < 0.05) were associated with hypertension after pregnancy.</p><p><b>CONCLUSIONS</b>Women with history of PE are associated with higher risk of postpartum hypertension. Increased blood pressure, abnormal glucose and lipid metabolism during pregnancy are major risk factors for postpartum hypertension.</p>