97 Association between hypertensive disorders of pregnancy and later risk of cardiovascular outcomes

Clare Oliver-Williams,Rupert Payne,David Stevens,Ian Wilkinson,Angela Wood,Gordon Smith

doi:10.1136/heartjnl-2019-bcs.94

Clare Oliver-Williams, Rupert Payne + Show 4 more

Open Access

https://doi.org/10.1136/heartjnl-2019-bcs.94

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Journal: Heart	Publication Date: May 1, 2019
License type: cc-by

Affiliation: University of Bristol, University of Cambridge

Abstract

IntroductionHypertensive disorders of pregnancy, especially pre-eclampsia, are associated with greater cardiovascular disease risk. However, the risk of specific cardiovascular outcomes associated with pre-eclampsia or gestational hypertension is unclear.MethodsCox regression analysis...

Highlights

Hypertensive disorders of pregnancy, especially pre-eclampsia, are associated with greater cardiovascular disease risk
Patients presenting with STEMI and mrEF carried an intermediate risk over long term follow up
Compared with women with normotensive pregnancies, there was a greater risk of any cardiovascular event for women with previous gestational hypertension, adjusted HR = 1.45 (1.31, 1.61), and pre-eclampsia, aHR = 1.69 (1.53–1.87)

Summary

Introduction

Hypertensive disorders of pregnancy, especially pre-eclampsia, are associated with greater cardiovascular disease risk. The risk of specific cardiovascular outcomes associated with pre-eclampsia or gestational hypertension is unclear. The objective of the evaluation of patients with chest pain is to identify acute coronary syndrome (ACS) and other serious cardiovascular conditions. No prior national study has evaluated readmission for serious cardiovascular events among the cohort of patients who are discharged with a diagnosis of non-specific chest pain. Structural cardiac adaptations caused by hypertension present a diagnostic challenge when differentiating from hypertrophic cardiomyopathy (HCM), using traditional imaging techniques such as echocardiography (echo). Cardiac magnetic resonance imaging (CMR) offers reproducible anatomical, functional quantification as well as myocardial tissue characterisation which discriminates between hypertension and HCM. Purpose To identify hypertensive individuals with undiagnosed HCM using CMR imaging. In keeping with ESC guidelines, end diastolic wall thickness (EDWT) 15mm identified individuals within the “grey zone” between hypertension and with a potential HCM Abstract

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Conclusion