Long-term cardiovascular repercussions in women with previous pregnancies complicated by severe hypertensive disease.

Abstract

Objective: To assess the long-term functional and structural repercussions of the heart and vessels in women with a history of severe preeclampsia (PE).

Methods: A cross-sectional study conducted at a tertiary hospital involving women 2-5 years postpregnancy, divided into three groups: isolated preeclampsia (de novo PE = 30), superimposed PE and/or chronic hypertension (PEs/HC= 60), and normal gestation (NG = 30). We evaluated age, body mass index (BMI), office systolic (SBP) and diastolic blood pressure (DBP), 24-h ambulatory blood pressure monitoring (ABPM), noninvasive central blood pressure (CBP) by tonometry (sphygmocor), pulse wave velocity (PWV - complior), and echocardiography (ViviDI-GE).

Results: Age (38 ± 5 years) and BMI (32.6 ± 6 k/m2) were higher in PEs/HC. Office SBP (mmHg) was higher in de novo PE (124.8 ± 11) and PEs/HC (133.6 ± 19) than NG (114.6 ± 9), and DBP (mmHg) was higher in PEs/HC (87.8 ± 12) than NG (73.3 ± 8) and de novo PE (80.4 ± 12). ABPM showed higher SBP in all periods for PEs/HC than NG and de novo PE. Central SBP was higher in PEs/HC and De novo PE compared to NG and De novo PE. Carotid-femoral PWV (m/s) was higher in PEs/HC (8.1 ± 2) than NG (6.8 ± 1) and de novo PE (7.0 ± 1). Echocardiography revealed increased septal thickness and left atrial diameter in PEs/HC, with a higher left ventricular (LV) mass index in de novo PE and PEs/HC than NG.

Conclusion: Women with previous de novo PE have higher office and central blood pressure values and greater ventricular mass compared to those with previous normal pregnancies. The most significant cardiovascular repercussions were observed in women with previous superimposed PE or chronic hypertension during pregnancy.