Women with Pregnancy Induced Hypertension have Higher Risk of Developing Essential Hypertension

Background: Hypertension is a significant health burden that leads to increased morbidity and mortality. There is limited data in literature on the association of pregnancy induced hypertension with the development of essential hypertension in future from this south Asian population of women who are at a higher risk of developing cardiovascular diseases as compared to men. Objectives: To determine the association of essential hypertension with Pregnancy induced hypertension in women presenting to medicine clinics. Methods: This was a case-control study conducted over 12 months in the out-patient medicine clinics of the Aga Khan University Hospital. Women patients aged \u3e18 years and \u3c 65 years were enrolled from the out-patient clinics. Cases were women who were diagnosed as hypertensive based on JNC VII criteria or who have pre hypertension and who had history of pregnancy in the past. Controls were women who were not hypertensive and who had history of pregnancy in the past. Women with secondary hypertension and those with primary infertility were excluded from the study. Primary outcome was hypertension and the main exposure was pregnancy induced hypertension. Data was analyzed using SPSS version 19.Mean (SD) and %(N) were used for descriptive and Logistic regression was used for calculating OR (95 %CI). Results: A total of 258 patients were enrolled: 51.6 %( 133) cases and 48.4 %( 125) controls. Of those enrolled, overall: Mean (SD) age was 44.6 (13.3), SBP was 131(24.0), DBP was 78.8(12.9), Number of pregnancy was 4.69 (2.87) {with 3.92 (2.68) live births and 0.717 (1.11) abortions}, 99.6% (257) were married, 36.0% (93) had family history of hypertension, 9.3% (24) performed 30 min physical activity\u3e4 days/week, 20.9% (54) had PIH [5% (13) developed hypertension in the 1st trimester of pregnancy, 4.3% (11) in the 2nd trimester , 10.9% (28) in the 3rd trimester]. On univariate regression analysis with hypertension as outcome; Odds Ratio (95 %CI) was 1.6 (95% CI, 0.88 to 3.0) p value 0.11 for pregnancy induced hypertension(PIH), 1.14(1.11,1.18) p value Conclusions: Women who develop hypertension in pregnancy are at higher risk of developing essential hypertension later on in life compared to women who do not have P