title: Longitudinal analysis of cardiovascular risk parameters in women with a history of hypertensive pregnancy disorders: the Doetinchem Cohort Study.
abstract: OBJECTIVE
  Women with hypertensive pregnancy disorders (HPD) are at increased risk of developing hypertension and cardiovascular disease later in life; however, it is not known how cardiovascular risk develops throughout life. We evaluated the longitudinal trends in cardiovascular risk factors in women after hypertensive pregnancy disorders compared with women with normotensive pregnancies.
  
  
  METHODS
  All women of the Doetinchem Cohort Study (1987-91), a population-based cohort study, were included.
  
  
  METHODS
  Women were examined (questionnaires and physical examination) four times at 5-year intervals. History of HPD was assessed from questionnaires. We compared 5-year changes in risk factors between women with and without HPD, by analysing longitudinal trends using generalised estimating equation analysis to estimate the effects of HPD and mean age, adjusting for treatment, body mass index (BMI), smoking and socio-economic status.
  
  
  METHODS
  Change over time in traditional cardiovascular risk factors, including systolic blood pressure (SBP) and diastolic blood pressure (DBP), BMI, total and high-density lipoprotein (HDL) cholesterol for women with and without a history of HPD.
  
  
  RESULTS
  A total of 2703 women with normotensive pregnancies (mean age 40.5 years, SD 10.4) and 689 women with a history of HPD (mean age 38.4 years, SD 9.5) were included. Compared with normotensive women, in women with a history of HPD, SBP was 2.8 mmHg higher (95% CI 1.7-3.9), DBP was 2.3 mmHg higher (95% CI 1.6-3.0) and BMI was 0.7 kg/m(2) higher (95% CI 0.4-1.1). Total cholesterol (-0.05; 95% CI -0.1 to 0.0) and HDL cholesterol (0.02; 95% CI -0.0 to 0.1) were similar in both groups. No difference in annual change in blood pressure or in the other risk factors was observed between women with and without a history of HPD.
  
  
  CONCLUSIONS
  Women with a history of HPD have higher levels of SBP, DBP and BMI compared with normotensive women, but the increase with ageing is similar in both groups.
authors: Department of Cardiology, Isala Klinieken, Zwolle, the Netherlands.
authors: J T
authors: JT
authors: Drost
authors: Y T
authors: YT
authors: van der Schouw
authors: A H E M
authors: AH
authors: Maas
authors: W M M
authors: WM
authors: Verschuren
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003971:Diastole; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D016014:Linear Models; D008137:Longitudinal Studies; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D012307:Risk Factors; D013599:Systole
chemical_list: D002784:Cholesterol
keywords: Blood pressure; cardiovascular risk; hypertensive pregnancy disorders; longitudinal analysis