Morphofunctional cardiac parameters in middle-aged women with a history of hypertension during pregnancy

Background: The role of extragenital pregnancy-related complications in the development of late cardiovascular disease is being widely investigated. The prevalence of heart failure, specifically the form with preserved ejection fraction, is higher among females. The association between gestational hypertension and heart failure with preserved ejection fraction has been the subject of extensive research.

The aim of the study was to investigate the morphofunctional parameters of the heart in women with a history of gestational hypertension.

Methods: This study investigated the morphofunctional parameters of the heart in 102 women aged 45–59 years with a history of arterial hypertension during at least one completed pregnancy. The participants underwent transthoracic echocardiography and were then interviewed regarding their history of hypertension during pregnancy. Twenty-six women had a history of arterial hypertension during pregnancy, whereas 70 women did not. Subsequently, the echocardiographic parameters between the groups were compared.

Results: Among participants with a body mass index >25 kg/m², the left ventricular myocardial mass index, which was adjusted for body surface area and height, was significantly higher in the those with a history of hypertension during pregnancy than in those without hypertension (88.6 ± 24.3 vs. 71.7 ± 15.3; p = 0.002 and 44.6 ± 14.3 vs. 32.8 ± 42.4 ; p = 0.004, respectively). Mitral annulus velocity was lower in women with pregnancy-related hypertension, which is a characteristic of impaired left ventricular relaxation. The detection rate of diastolic dysfunction was higher in the group of women with hypertension during pregnancy: 10 (38.5%) compared to 12 (17.1%) (p = 0.03). Moreover, significant differences (p = 0.003) in epicardial adipose tissue thickness were identified: 7.5 (5.5; 9) mm in the group of women with hypertension during pregnancy compared to 5 (4; 7) mm in those without.

Conclusions: In middle-aged women, the most pronounced changes were observed in diastolic dysfunction parameters and in cardiac morphometric characteristics. Furthermore, hypertension complications during pregnancy influence epicardial adipose tissue thickness, a key predictor of cardiovascular complications.