title: History of gestational hypertension is associated with the metabolic syndrome and masked hypertension but not arterial stiffness in women with essential hypertension.
abstract: The underlying mechanisms of subsequent increased risk of cardiovascular disease with a history of gestational hypertension (GH) are not known. Untreated hypertensive women (n=155, age 43+/-1 years) underwent ambulatory blood pressure (BP) monitoring and assessment of aortic pulse wave velocity (PWV) and augmentation index (AIx). Despite identical clinic BP readings, the group of women with GH (n=54) had higher (P=.002) ambulatory daytime systolic BP levels and a greater number of extreme nocturnal dippers (P=.005) than the group without GH. Women with GH had higher body mass index (P=.003), greater waist circumference (P=.02), higher levels of triglycerides (P=.002), lower levels of high-density lipoprotein cholesterol (P=.004), a higher prevalence of the metabolic syndrome (P<.05) and microalbuminuria (P=.004), higher plasma renin activity (P=.03), and higher aldosterone levels (P=.01). There was no significant difference in PWV and AIx between the 2 groups. The higher prevalence of the metabolic syndrome, microalbuminuria, masked hypertension, and activation of the renin-angiotensin-aldosterone system but not arterial stiffness may explain the subsequent propensity to high BP and cardiovascular disease in women with GH.
authors.affiliation: Department of Pharmacology and Therapeutics, Trinity College, Dublin, Ireland. mahmuda@tcd.ie
authors.forename: Azra
authors.initials: A
authors.lastname: Mahmud
authors.forename: Mehnaz
authors.initials: M
authors.lastname: Jatoi
authors.forename: Yei Roi
authors.initials: YR
authors.lastname: Chee
authors.forename: John
authors.initials: J
authors.lastname: Feely
mesh_terms: D000328:Adult; D001158:Arteries / Q000473:pathology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004548:Elasticity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology*; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D011247:Pregnancy; D012084:Renin-Angiotensin System / Q000502:physiology