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ADVERSE CARDIOVASCULAR RISK PROFILE IN MIDDLE AGE WOMEN WITH A PAST HISTORY OF GESTATIONAL HYPERTENSION
J Girouard, Y Gigučre, AA Kharfi, J-C Forest
Quebec, Quebec
BACKGROUND: Gestational hypertension (GH) is a disease confined to the pregnancy. However, it appears that this pregnancy complication may confer an increased risk of cardiovascular disease later in life, but data from prospective studies are scarce.
METHODS: Women with a history of GH were selected from a cohort of 5000 nulliparous women prospectively recruited between 1989 and 1996. They were invited to participate in a follow up nested case/control study evaluating the cardiovascular risk profile. Cases of GH were matched for age and year of delivery with women with a history of uncomplicated first pregnancy. Each participant filled a questionnaire and anthropometrical and biochemical parameters were measured during a 3-hour visit with a research nurse.
RESULTS: 168 cases and their matched control have been evaluated. Body-mass index, waist circumference and waist/hip ratio were significantly higher in cases compare to controls (p < 0,001). Systolic (115 vs
108 mmHg) and diastolic (75 vs 70 mmHg) blood pressures were significantly higher in affected women (p < 0,0001). The lipid profile showed lower HDL-cholesterol (1,30 vs 1,42; p < 0,0005), higher triglycerides (1,20 vs 1,03; p = 0,025) and a higher total cholesterol/HDL-C ratio (3,81 vs 3,37; p < 0,0008) in cases. Fasting blood glucose (5,2 vs 5,0) and fasting insulin (119 vs 91) were also significantly higher in women with a past history of gestational hypertension (p < 0,002). Moreover, 19,0% of the cases compared to 6,5% of the controls had the metabolic syndrome based on NCEP expert panel criteria (
CONCLUSIONS: Despite the relatively young age of our study sample (mean = 34,8y), we were able to find the presence of an unfavourable cardiovascular risk profile in women with a past history of GH. This suggests that these women would benefit from a long term follow up focussing on the prevention against cardiovascular disease.
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