title: Cardiovascular and metabolic characteristics 40 years after hypertensive pregnancies: a long-term follow-up study of mothers.
abstract: OBJECTIVE
  Maternal cardiovascular morbidity is increased after hypertensive pregnancies (HTP). The pathways from complicated pregnancies to future cardiovascular disease are complex. The aim of the present study was to test the hypothesis that different cardiovascular mechanisms are changed in women who experienced HTP four decades earlier in comparison to women with normotensive pregnancies.
  
  
  METHODS
  One hundred and five women (50 with hypertensive and 55 with normal pregnancies) were examined with anthropometric measurements; office blood pressure, ambulatory blood pressure and central blood pressure, pulse wave velocity, augmentation index, intimal-media thickness, echocardiography and laboratory measurements. In addition another 204 women were followed-up by a questionnaire regarding their pregnancy 40 years ago, as well as their present health status and medications.
  
  
  RESULTS
  Women with HTP had more often diagnosed hypertension when compared with women with normal pregnancies (50 vs. 31%, respectively; P = 0.046), but the groups did not differ in any blood pressure levels. HTP were associated with higher pulse wave velocity (8.8 m/s vs. 7.8 m/s, P = 0.021), and higher levels of P-glucose (5.7 mmol/l vs. 5.2 mmol/l, P = 0.022), P-HbA1c (4.4% vs. 4.2%, P = 0.010) and noradrenaline (2.45 mmol/l vs. 2.11 mmol/l, P = 0.040) when compared with normotensive pregnancies. Women followed up with a questionnaire reported deteriorated cardiovascular health compared to women attending the clinical investigations of the study.
  
  
  CONCLUSIONS
  HTP are associated with impairment in vascular function and metabolic status 40 years postpartum despite well controlled blood pressure levels.
authors: Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska University Hospital, Sahlgrenska Academy, Göteborg University, Sweden. anna-clara.collen@vgregion.se
authors: Anna-Clara
authors: AC
authors: Collén
authors: Margareta
authors: M
authors: Hellgren
authors: Helena
authors: H
authors: Gustafsson
authors: Magnus C
authors: MC
authors: Johansson
authors: Karin
authors: K
authors: Manhem
mesh_terms: D000368:Aged; D001794:Blood Pressure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000378:metabolism* / Q000503:physiopathology*; D008875:Middle Aged; D009035:Mothers; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000378:metabolism* / Q000503:physiopathology*