More evidence links extreme hypertension during pregnancy to long-term problems

Women who develop preeclampsia, a form of dangerously high blood pressure during pregnancy, can cope with a wide variety of heart problems long after childbirth, a research study concludes.

Preeclampsia has long been badociated with an increased risk of events such as heart attacks and strokes years later, but women often show no symptoms as long as they do not suffer from pain. a problem putting their lives in danger. For the current badysis, the researchers looked at the results of 13 previously published studies that badessed women's hearts with echocardiography to look for early warning signals.

"Previous studies had shown cardiac dysfunction in women with a history of pre-eclampsia, but this article brings together the results of these studies to try to better understand the extent of the problem and patterns of dysfunction," said lead author Archana Thayaparan, researcher at Western Health in Victoria, Australia.

"This is important for patients because no major studies have been conducted and most women with preeclampsia are unaware of the potential long-term consequences and increased risk of heart disease and stroke. of stroke, "said Thayaparan by e-mail.

Gestational hypertension, which occurs during pregnancy in women who do not usually have high blood pressure, is quite common and affects 6-8% of pregnant women. This condition can progress to a more serious and potentially fatal version of high blood pressure, called preeclampsia, later in pregnancy.

Women with preeclampsia are more likely to develop a "diastolic dysfunction", which occurs when the heart does not fill up properly with blood and is a precursor to a form of heart failure.

In the study, about 19% of women with a history of preeclampsia developed diastolic dysfunction, compared to 5.4% of women with uncomplicated pregnancies.

With a history of preeclampsia, about 25% of women developed heart failure 4 to 10 years after giving birth, compared with 7% of women whose pregnancy was not complicated, the researchers note in the Australian Journal of Ultrasonography .

This suggests that women with a history of preeclampsia should have regular echocardiograms to monitor their heart and detect any changes that may be causing no symptoms, the study authors conclude.

The study was not designed to determine whether preeclampsia is directly responsible for subsequent heart problems, or whether it could be an early sign of existing problems that appear under the pressure of pregnancy on the body of a woman.

"Previous research has shown that traditional cardiovascular risk factors such as BMI and blood pressure play a central role in the development of cardiovascular disease in women with preeclampsia," said Eirin Haug, health researcher. at the Norwegian University of Science and Technology in Trondheim, which did not participate in the study.

Doctors are now advising women with a history of pre-eclampsia to change their lifestyle, such as losing weight, exercising, following a heart-healthy diet, and getting their blood pressure checked regularly. Haug said by email.

"We still have no evidence of the effect of screening and lifestyle modifications on cardiovascular risk reduction in these women," Haug said. "More research is needed to design effective strategies for preventing cardiovascular disease in this group of women."

SOURCE: https://bit.ly/2K7xfPb Australasian Journal of Ultrasound Medicine, posted July 2, 2019.