For a study, researchers sought to compare CV risk variables and subclinical cardiovascular disease (CVD) 20-30 years later; in a well-characterized cohort of ethnically diverse individuals with and without a history of Hypertensive disorders of pregnancy (HDP) 10 years before.

It was a prospective study of individuals with and without HDP who had in-person consultations with echocardiography, arterial tonometry, and flow-mediated brachial artery dilation ≥10 years ago (2005-2007).

A total of 135 patients (84 with and 51 without a history of HDP) completed examinations, with 85% self-identifying as Black. Patients with a history of HDP had a 2.4-fold higher risk of developing new hypertension compared to those without HDP (56.0% vs. 23.5%; adjusted relative risk: 2.4; 95% CI: 1.39-4.14), with no differences in measures of left ventricular structure, global longitudinal strain, diastolic function, arterial stiffness, or endothelial function. Patients with or without a history of HDP had greater left ventricular remodeling, including greater relative wall thickness; worse diastolic function, including lower septal and lateral e’ and E/A ratio; more abnormal longitudinal strain; and higher effective arterial elastance than patients without hypertension.

After 10 years following HDP, they discovered a 2.4-fold higher incidence of hypertension. Regardless of HDP history, differences in noninvasive indicators of CV risk were predominantly driven by the hypertension diagnosis, indicating that the known long-term risk of CVD following HDP may primarily be a result of hypertension development.

Reference: jacc.org/doi/10.1016/j.jacc.2022.03.383