Abstract 12318: Echocardiographic or Blood Pressure Screening of Women With Past Pre-Eclampsia and Gestational Hypertension: The Western Health Survey of Heart Failure Risk After Pregnancy Hypertension Pilot Survey

Abstract

Introduction: Pre-eclampsia (Pec) and gestational hypertension (GHT) are potential explanations for the female preponderance of heart failure with preserved ejection fraction. How and when to use this information clinically is unclear. Hypothesis: We hypothesized that subclinical disturbances of left ventricular (LV) structure and function (stage B heart failure, SBHF) are more common at 5-10 years post-partum in women with a history of Pec compared with women with GHT or uneventful pregnancies. Methods: The proportion of SBHF were compared between 25 women with Pec, 16 with GHT or normal pregnancy. Sub-group analysis comparing patients with and without hypertension at follow-up were also conducted. Results: Among 41 participants (age 40±6 years), followed at 9 years, SBHF was reported in 35% participants with Pec and 53% with GHT ( p =0.32). Diastolic blood pressure was significantly higher in patients with SBHF than without (94±21 vs. 81±13 mmHg, p=0.035), and a similar trend was observed with systolic blood pressure (147±42 vs. 128±22mmHg, p=0.099). SBHF was observed in 6 (55%) of 11 pts with hypertension at follow-up, but only in 7 (32%) of 22 without ( p =0.27). Mean LV end-diastolic volume (117.2±19.1 vs. 93.3±13.1mL, p =0.03), LV end-systolic volume (51.9±7.5 vs. 42±7 mL, p= 0.04), LV mass index (73±8.6 vs. 67.3±14.6mmHg, p=0.41), E/e’ (Sept: 9.7±2.7 vs. 7.5±1.7, p =0.009; Lat: 7.4±2.6 vs. 5.5±1.7, p =0.02) were higher in participants with hypertension than without. Conclusions: 9 years after pregnancy, SBHF was prevalent in pts with both previous Pec and GHT, but was not significantly different between the entities. Echocardiographic screening may add little to blood pressure follow-up in the identification of HF risk.