Abstract: FR-PO556

Pregnancy Is Associated with Higher Central Systolic and Pulse Pressures in Later Life

Session Information

Category: Hypertension

  • 1102 Hypertension: Basic and Experimental - Renal Causes and Consequences

Authors

  • Pelletier, Karyne, Hopital du Sacre-Coeur de Montreal, Montreal, Alberta, Canada
  • Cote, Anne-Marie, CHUS - Hopital Fleurimont, Sherbrooke, Quebec, Canada
  • Madore, Francois, Hopital du Sacre-Coeur de Montreal, Montreal, Alberta, Canada
  • Goupil, Remi, Hopital du Sacre-Coeur de Montreal, Montreal, Alberta, Canada
Background

Healthy pregnancy has been associated with increased arterial stiffness and central hemodynamics which normalises after delivery. Whether these changes portend to long-term changes in central blood pressures (BP) remains unknown.

Methods

Using the CARTaGENE populational database, central hemodynamic parameters were adjusted and compared between 1) women without previous pregnancies, 2) women with previous pregnancies of less than 20 weeks only and 3) women with previous pregnancies of longer term.

Results

Of 10,266 female CARTaGENE participants, 8,662 had previous pregnancies (666 with previous pregnancies ≤ 20 weeks only). Baseline characteristics are presented in the below table. After adjustment for important covariables, central systolic BP, central pulse pressure and augmentation index were higher in women with previous pregnancies ≤ 20 weeks than in women without pregnancies and with > 20 weeks pregnancies (p-values for trend <0.001, 0.001 and 0.04 respectively).

Conclusion

In this cohort, pregnancy was associated with increased central BP and indices of arterial stiffness in later life, the importance of which was greater when pregnancies longer than 20 weeks occurred. To what extent these differences could be explained by complications during pregnancy requires further investigations.

CharacteristicsNo pregnancy
(n=1,604)
Pregnancy ≤ 20 weeks or less only (n=666)Pregnancy > 20 weeks (n=7,996)
Age54 ± 853 ± 7 a54 ± 8 b
Age of first pregnancy-27 ± 725 ± 5 b
Diabetes7%7%7%
Cardiovascular disease4%4%4%
Treated hypertension19%15% a22% ab
Brachial systolic BP119 ± 15118 ± 17120 ± 16 ab
Brachial pulse pressure47 ± 1147 ± 1148 ± 11 ab
Heart rate70 ± 1069 ± 1169 ± 11 a
 
Adjusted central hemodynamic parameters
Central systolic BP113.2 (112.7, 113.7)113.5 (112.9, 114.1)114.1 (113.7, 114.6) ab
Central pulse pressure41.1 (40.3, 41.8)41.4 (40.6, 42.3)42.4 (41.8, 43.1) ab
Augmentation index31.2 (30.3, 32.0)31.7 (30.6, 32.7)31.8 (31.1, 32.6) a

a p<0.05 vs no pregnancy; b p<0.05 vs pregnancy 20 weeks or less. Values are reported as mean ± standard deviation or as estimated marginal means (95%CI) adjusted for age, BMI, diabetes, cardiovascular disease, active smoking, total cholesterol, HDL-cholesterol, eGFR, uric acid, TSH, heart rate, mean BP and use of renin-angiotensin blockers, calcium channel blockers, diuretics, beta-blockers, statins and aspirin.