Disproportionate pregnancy-induced myocardial hypertrophy in women with essential hypertension


Autoria(s): Zanati Bazan, Silméia Garcia; Borges, Vera Therezinha Medeiros; Martin, Luis Cuadrado; Magalhães, Claudia Garcia; Hueb, João Carlos; Silveira, Liciana Vaz de Arruda; Peraçoli, José Carlos; Matsubara, Beatriz Bojikian
Contribuinte(s)

Universidade Estadual Paulista (UNESP)

Data(s)

27/05/2014

27/05/2014

01/06/2013

Resumo

BACKGROUND Pregnancy and arterial hypertension (AH) have a prohypertrophic effect on the heart. It is suspected that the 2 conditions combined cause disproportionate myocardial hypertrophy. We sought to evaluate myocardial hypertrophy (LVH) and left ventricular function in normotensive and hypertensive women in the presence or absence of pregnancy.METHODS This prospective cross-sectional study included 193 women divided into 4 groups: hypertensive pregnant (HTP; n = 57), normotensive pregnant (NTP; n = 47), hypertensive nonpregnant (HTNP; n = 41), and normotensive nonpregnant (NTNP; n = 48). After clinical and echocardiographic evaluation, the variables were analyzed using 2-way analysis of variance with pregnancy and hypertension as factors. Left ventricular mass (LVM) was compared using nonparametric analysis of variance and Dunn′s test. Predictors of LVH and diastolic dysfunction were analyzed using logistic regression (significance level, P < 0.05).RESULTS Myocardial hypertrophy was independently associated with hypertension (odds ratio (OR) = 11.1, 95% confidence interval (CI) = 3.2-38.5; P < 0.001) and pregnancy (OR = 6.1, 95% CI = 2.6-14.3; P < 0.001) in a model adjusted for age and body mass index. Nonpregnant women were at greater risk of LVH in the presence of AH (OR = 25.3, 95% CI = 3.15-203.5; P = 0.002). The risk was additionally increased in hypertensive women during pregnancy (OR = 4.3, 95% CI = 1.7-10.9; P = 0.002) in the model adjusted for stroke volume and antihypertensive medication. Although none of the NTNP women presented with diastolic dysfunction, it was observed in 2% of the NTP women, 29% of the HTNP women, and 42% of the HTP women (P < 0.05).CONCLUSIONS Hypertension and pregnancy have a synergistic effect on ventricular remodeling, which elevates a woman's risk of myocardial hypertrophy. © 2013 © American Journal of Hypertension, Ltd 2013. All rights reserved.

Formato

816-821

Identificador

http://dx.doi.org/10.1093/ajh/hpt023

American Journal of Hypertension, v. 26, n. 6, p. 816-821, 2013.

0895-7061

1941-7225

http://hdl.handle.net/11449/75535

10.1093/ajh/hpt023

WOS:000318693600014

2-s2.0-84877780882

Idioma(s)

eng

Relação

American Journal of Hypertension

Direitos

closedAccess

Palavras-Chave #blood pressure #echocardiography #hypertension #pregnancy #pressure overload #ventricular function #ventricular remodeling. #adult #body mass #controlled study #diastolic dysfunction #essential hypertension #female #heart left ventricle function #heart left ventricle mass #heart stroke volume #heart ventricle hypertrophy #human #major clinical study #priority journal
Tipo

info:eu-repo/semantics/article