Hypertension and pregnancy: Opportunity of etiological assessment and stratification of cardiovascular risk

Background Hypertension during pregnancy is the leading marker of risk for maternal and fetal morbidity and mortality. Hypertension during pregnancy occurs in 6 to 10% of pregnancies in the USA and in Europe. Because of the potential severity, of hypertension-related diseases for both mother and infant, medical practice needs to be optimized. Learned Societies consider the different various forms of pregnancy-related hypertension as a specific cardio-vascular (CV) situation that is included in the stratification of risk for women. Purpose To determine the interest of the systematic search for a potential etiological factor and the stratification of the CV risk in any women with some history of hypertension during pregnancy. Methods Between January 2010 to December 2015, we have retrospectively included 175 women with a prior history of hypertensive pregnancy in our excellence center of hypertension. Results Secondary hypertension was found in 25% of women, 58% of whom had primary hyperaldosteronism. A low renin hypertension was present in 30%. Women with secondary hypertension have more severe microalbuminuria ( P  = 0.019), more dilated left atrium ( P  = 0.051) and higher left ventricle pressure ( P  = 0.043). The prevalence of CV risk factors was high in this population: dyslipidemia in 78%, diabetes in 11%, smoking in 21%, CV heredity in 32% and metabolic syndrome in 57%. Thus, 58% of women were at high CV risk. Conclusion Women who experienced hypertension during pregnancy should systematically perform a CV risk assessment and a coordinated follow-up.