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429: Echocardiographic markers aid in risk stratification of women with persistent hypertension after preeclamptic pregnancy

      Objective

      Women diagnosed with preeclampsia (PEC) have a higher incidence of chronic hypertension (HTN), heart failure, stroke, and other forms of cardiovascular disease. We hypothesized parameters on echocardiography (ECHO) performed at diagnosis of PEC would be associated with subsequent cardiovascular risk.

      Study Design

      Women with PEC were prospectively recruited from the Johns Hopkins Health System between September 2014 – December 2015. We included singleton pregnancies > 23 weeks and diagnosis of PEC with severe features (PEC-SF) or PEC-SF superimposed on chronic HTN and excluded known maternal heart valve disease, previous cardiac surgery, known cardiomyopathy, pulmonary hypertension, history of pulmonary embolism, or interstitial lung disease. ECHO was performed at time of PEC-SF diagnosis. Participants were assessed for HTN 3 years after delivery, defined as systolic blood pressure (BP) >130 mmHg, diastolic BP > 80 mmHg, or on anti-hypertensive therapy. Outcome data were collected via phone and electronic medical records. Baseline differences were tested using parametric or non -parametric tests as appropriate; significance was defined as p-value < 0.0007 using Bonferroni’s correction.

      Results

      17 women were without HTN at 3 years and 28 women had HTN 3 years after diagnosis of PEC-SF. The groups did not differ in age, race, or gestational age. There were significantly more women with pre-pregnancy HTN in the HTN group and a trend towards higher body mass index (Table 1). Women with HTN 3 years after PEC-SF diagnosis had increased left ventricular (LV) septal wall thickness when compared to women without HTN (Table 1). A restricted, sensitivity analysis including only women without pre-pregnancy HTN continued to show significantly increased LV septal wall thickness in PEC-SF with HTN at 3 years versus PEC-SF without HTN (Figure 1).