Disproportionate pregnancy-induced myocardial hypertrophy in women with essential hypertension

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dc.contributor.authorZanati Bazan, Silméia Garcia [UNESP]
dc.contributor.authorBorges, Vera Therezinha Medeiros [UNESP]
dc.contributor.authorMartin, Luis Cuadrado [UNESP]
dc.contributor.authorMagalhães, Claudia Garcia [UNESP]
dc.contributor.authorHueb, João Carlos [UNESP]
dc.contributor.authorSilveira, Liciana Vaz de Arruda [UNESP]
dc.contributor.authorPeraçoli, José Carlos [UNESP]
dc.contributor.authorMatsubara, Beatriz Bojikian [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2014-05-27T11:29:35Z
dc.date.available2014-05-27T11:29:35Z
dc.date.issued2013-06-01
dc.description.abstractBACKGROUND 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.en
dc.description.affiliationDepartment of Internal Medicine Botucatu Medical School-Unesp São Paulo State University, São Paulo
dc.description.affiliationDepartment of Gynecology and Obstetrics Botucatu Medical School-Unesp São Paulo State University, São Paulo
dc.description.affiliationDepartment of Biostatistics Biosciences Institute-Unesp São Paulo State University, São Paulo
dc.description.affiliationUnespDepartment of Internal Medicine Botucatu Medical School-Unesp São Paulo State University, São Paulo
dc.description.affiliationUnespDepartment of Gynecology and Obstetrics Botucatu Medical School-Unesp São Paulo State University, São Paulo
dc.description.affiliationUnespDepartment of Biostatistics Biosciences Institute-Unesp São Paulo State University, São Paulo
dc.format.extent816-821
dc.identifierhttp://dx.doi.org/10.1093/ajh/hpt023
dc.identifier.citationAmerican Journal of Hypertension, v. 26, n. 6, p. 816-821, 2013.
dc.identifier.doi10.1093/ajh/hpt023
dc.identifier.issn0895-7061
dc.identifier.issn1941-7225
dc.identifier.lattes8499437381595614
dc.identifier.lattes6990977122340795
dc.identifier.lattes4923203168446615
dc.identifier.scopus2-s2.0-84877780882
dc.identifier.urihttp://hdl.handle.net/11449/75535
dc.identifier.wosWOS:000318693600014
dc.language.isoeng
dc.relation.ispartofAmerican Journal of Hypertension
dc.relation.ispartofjcr3.046
dc.relation.ispartofsjr1,322
dc.rights.accessRightsAcesso restrito
dc.sourceScopus
dc.subjectblood pressure
dc.subjectechocardiography
dc.subjecthypertension
dc.subjectpregnancy
dc.subjectpressure overload
dc.subjectventricular function
dc.subjectventricular remodeling.
dc.subjectadult
dc.subjectbody mass
dc.subjectcontrolled study
dc.subjectdiastolic dysfunction
dc.subjectessential hypertension
dc.subjectfemale
dc.subjectheart left ventricle function
dc.subjectheart left ventricle mass
dc.subjectheart stroke volume
dc.subjectheart ventricle hypertrophy
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectpriority journal
dc.titleDisproportionate pregnancy-induced myocardial hypertrophy in women with essential hypertensionen
dc.typeArtigo
dcterms.licensehttp://www.oxfordjournals.org/access_purchase/self-archiving_policyb.html
unesp.advisor.lattes7805298466001457[6]
unesp.author.lattes8499437381595614
unesp.author.lattes6990977122340795
unesp.author.lattes4923203168446615
unesp.author.orcid0000-0001-8931-5495[6]
unesp.author.orcid0000-0002-0607-8189[1]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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