Cardiac Abnormalities in Hispanic Women with Prior De Novo Hypertensive Disorders of Pregnancy

BackgroundHypertensive disorders of pregnancy (HDP) are associated with longer-term maternal risks for cardiovascular disease for reasons that remain incompletely understood. MethodsThe Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multi-center community-based cohort of Hispanic/Latino adults recruited 2008 to 2011 was used to evaluate the associations of history of de novo HDP (gestational hypertension, preeclampsia, eclampsia) with echocardiographic measures of left ventricular (LV) structure and function in Hispanic/Latina women with [≥]1 prior pregnancy and the proportion of association mediated by current hypertension. ResultsThe study cohort included 5,168 Hispanic/Latina women. Prior de novo HDP was reported by 724 (14%) of the women studied with an average age of 58.7 {+/-} 9.7 years at time of echocardiogram and was associated with lower ejection fraction -0.66 (-1.21, -0.11), greater relative wall thickness (RWT) 0.09 (0, 0.18), and 1.39 (1.02, 1.89) greater odds of abnormal LV geometry after adjusting for blood pressure and other risk factors. The proportion of association mediated by current hypertension between HDP and LV ejection fraction was 0.09 (95% CI 0.03, 0.45), any abnormal LV geometry was 0.14 (0.12, 0.48), LV RWT 0.28 (0.16, 0.51), concentric LVH was 0.31 (0.19, 0.86), and abnormal LV diastolic dysfunction was 0.58 (0.26, 1.79). ConclusionsIn a large cohort of Hispanic/Latina women those with de novo HDP had detectable and measurable subclinical alterations in cardiac structure and both systolic and diastolic dysfunction that were only partially mediated by current hypertension.