title: Pre-eclampsia and risk of subsequent hypertension: in an American Indian population.
abstract: OBJECTIVE
  Pre-eclampsia (PE) shares a number of proposed pathophysiologic mechanisms related to those implicated in cardiovascular disease (CVD), such as endothelial dysfunction, inflammation, insulin resistance, and impaired renal regulation. PE has also been associated with subsequent hypertension, CVD, and related mortality in later life.
  
  
  METHODS
  At follow-up, the four most recent blood pressures, body mass index (BMI), and use of hypertensive medications were recorded from clinic visits of 130 PE cases and 289 normal pregnancies. Student's t test, Chi-square testing, multivariate linear, and logistic regression were used in analysis.
  
  
  RESULTS
  Follow-up measurements occurred a mean of 13.11 years post PE pregnancy. Multivariate linear regression showed a significant and independent association between current systolic blood pressure and previous history of PE (β = 4.47, p = 0.04), while adjusting for age, BMI, and blood pressure from 1 year prior to and up to the 20th week of gestation. A similarly adjusted multivariate logistic regression model found an odds ratio of 3.43, 95% CI 1.83-6.43, p = 0.001 for subsequent hypertension. Logistic regression analysis of the quartile with follow-up of less than 7.19 years also shows independent association of prior PE with subsequent hypertension.
  
  
  CONCLUSIONS
  PE appears to confer risk of subsequent hypertension on this cohort of American Indian women within as little as 8 years. This risk is independent of additional risk factors such as increased age, BMI, and blood pressure prior to 20 weeks of gestation. There is evidence of increased risk among those with more severe PE.
authors.affiliation: a Turtle Mountain Community College , Natural Science Department , Belcourt , North Dakota , USA.
authors.forename: Lyle G
authors.initials: LG
authors.lastname: Best
authors.affiliation: b University of North Dakota, School of Medicine , Family and Community Medicine Department , Grand Forks , North Dakota , USA.
authors.forename: Laramie
authors.initials: L
authors.lastname: Lunday
authors.affiliation: b University of North Dakota, School of Medicine , Family and Community Medicine Department , Grand Forks , North Dakota , USA.
authors.forename: Elisha
authors.initials: E
authors.lastname: Webster
authors.affiliation: b University of North Dakota, School of Medicine , Family and Community Medicine Department , Grand Forks , North Dakota , USA.
authors.forename: Gilbert R
authors.initials: GR
authors.lastname: Falcon
authors.affiliation: b University of North Dakota, School of Medicine , Family and Community Medicine Department , Grand Forks , North Dakota , USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Beal
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007198:Indians, North American / Q000706:statistics & numerical data*; D008875:Middle Aged; D009658:North Dakota / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
keywords: Case–control study; hypertension; multivariable analysis; preeclampsia