Stricker, Christian (2025) Cardiovascular disease screening in women after hypertensive disorder of pregnancy; time for a tailored intervention. thesis, Medicine.
Full text available on request.Abstract
Hypertensive disorders of pregnancy (HDP), including pregnancy-induced hypertension and pre-eclampsia, affect up to 10% of pregnancies and double the risk of cardiovascular disease (CVD) later in life. This risk may stem from a preexisting predisposition, pregnancy-induced risk factors due to HDP, or both. After pregnancy, women with HDP face higher risks of chronic hypertension, renal dysfunction, dyslipidemia, diabetes, and subclinical atherosclerosis. To address this, the Wilhelmina Children’s Hospital offers CVD screening at least six months postpartum for women with HDP. Currently, all receive a uniform, comprehensive screening through the UCC-SMART. This study assessed 305 women from UCC-SMART (2012–2022) against a normotensive pregnancy group to evaluate abnormal CVD findings by HDP phenotype. Our goal was to, based on this assessment, evaluate the potential for customized screening. Postpartum hypertension was significantly more prevalent in the HDP group (p = 0.004), with early-onset PE showing the worst profile. Per case analysis showed incidence of adverse CV follow up outcomes such as end-stage renal disease and myocardial infarction in women with early-onset PE. The cox regression model demonstrated that HDP was significant in the general development of CVD and specifically hypertension (p=0.016 and p=0.049 respectively), though other individual CVD outcomes lacked significance. Our findings reinforce the link between HDP and the development of postpartum hypertension. Additionally, we demonstrate a clinically significant relation between early-onset pre-eclampsia and CVD in women with existing comorbidities. While the UCC-SMART is unsuitable as a uniform intervention, we conclude that tailored screening based on HDP phenotype is feasible.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Depmann, Dr. M. and Versluis, Dr. M.A.C. |
| Faculty: | Medical Sciences |
| Date Deposited: | 08 May 2026 13:16 |
| Last Modified: | 08 May 2026 13:16 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3947 |
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