21 Hypertensive disorders in pregnancyiovascular disease risk and metabolic syndrome later in life

Abstract

Introduction Preeclampsia (PE) and cardiovascular disease (CVD) have similar pathophysiological mechanisms and they also share some risk factors. The relationship between hypertensive disorders in pregnancy and CVD has not been totally elucidated; perhaps the metabolic stress and vascular injury may contribute to increase this future risk in such women. Objectives Investigate correlation between hypertensive disorders in pregnancy and incidence of postpartum CVD and metabolic syndrome. Methods Case-control study with a total of 65 women (45 normal pregnancy and 20 gestational hypertension). These volunteer patients were submitted to clinical, laboratorial and nutritional evaluation (bioimpedance BIODYNAMICS 310e, USA). The risk scores were estimated by using Findrisc Diabetes Risk Calculator (FDRC) and Framingham Risk Score ATP III (FRS-ATPIII); diagnosis of metabolic syndrome was based on the International Diabetes Federation (IDF) worldwide definition. Results Mean age of control group (CG) was 47.5 years and of gestational hypertension group (HG) was 43.8 years. The mean period postpartum that those patients were evaluated was 12.4 years in HG and 18.0 years in CG. Half of the HG had preeclampsia. Chronic hypertension (CH) was observed in 70% of HG and 24% of CG (p ⩽ 0.05). FDRC indicated high risk of diabetes over 10 years in 45% of HG and 21% of CG. Metabolic syndrome was present in 75% of HG and 26.6% in CG (p ⩽ 0.05). The mean body mass index (BMI) was 31.5 kg/m2 (obese) in HG and 26.5 kg/m2 (overweight) in CG. The body fat percentage detected by bioimpedance was similar, 38.5% in HG and 35.8% in CG. The FRS-ATPIII indicated low risk of CVD over 10 years in both groups. Conclusions The incidence of CH and metabolic syndrome appears to be increased in women who had hypertensive disorders in pregnancy, especially PE. A higher risk of developing diabetes over 10 years was also found in HG. The investigation of the history of hypertension during pregnancy may help preventing and early diagnosing those comorbidities. Fapesp n° 2014/00213-7