BLOOD-PRESSURE AND RENAL-FUNCTION 7 YEARS AFTER PREGNANCY COMPLICATEDBY HYPERTENSION

Objective To assess the occurrence of chronic hypertension and renal d isorder after gestations complicated by pregnancy induced hypertension or pre-eclampsia and to define background factors and laboratory anal yses at follow up examination which discriminate between women who rem ain normotensive and those who develop hypertension. Setting Swedish u niversity hospital. Subjects Women with pregnancy induced hypertension (PIH) (n = 49), pre-eclampsia (n = 45) or a normotensive pregnancy (n = 44) during 1986. Design Subjects were reviewed in 1993 with regard to chronic hypertension and renal disorder. Plasma concentrations of c reatinine, urea, uric acid, calcium and albumin were measured, and uri ne was examined for the presence of microalbuminuria and erythrocyte e xcretion rate. Those with and without hypertension at follow up were c ompared with regard to the renal function tests and possible features in the history which might predict chronic hypertension. Results Women with a history of pregnancy induced hypertension or pre-eclampsia had an increased risk, relative to controls, for hypertension at follow u p (37% and 20% vs 2%; P < 0.001), microalbuminuria (14% and 20% vs 2%; P < 0.05) and demonstrated increased plasma levels of albumin correct ed calcium (2.41 [SE 0.02] and 2.40 [0.01] vs 2.32 [0.01] mmol/l; P < 0.001). The only factors significantly associated with hypertension at follow up were the presence of microalbuminuria (P = 0.0008) and havi ng had a delivery prior to the index pregnancy (P = 0.0017). Conclusio ns The risk for chronic hypertension seven years after a pregnancy com plicated with pregnancy induced hypertension or pre-eclampsia is consi derably increased. The presence of hypertension at follow up is closel y related to residual renal disorder.