Background: Hypertension in pregnancy affects 3–8% of women in the UK, accounting for ∼ 6 maternal deaths each year, foetal growth restriction, prematurity and still birth. Both gestational hypertension (GHT) and pre-eclampsia (PET) are associated with increased cardiovascular (CV) risk in later life. Commonly, research excludes GHT or fails to investigate it separately to PET. Our study explores the haemodynamic consequences in later life, of hypertension in pregnancy.

Method: Data from 545 women, aged > 40 years (mean age 62 years) were analysed. Subjects underwent detailed anthropometric and haemodynamic measurement including blood pressure, aortic stiffness, wave reflections (SphygmoCor) and cardiac output (InnoCor) and completed a questionnaire regarding pregnancy. Subjects were categorised as Never pregnant (NEP), Normotensive in pregnancy (NOP), GHT and PET.

Findings: There was a positive association between hypertension in pregnancy and seated brachial diastolic blood pressure (SBDP;P=0.001), seated central systolic and diastolic BP (P= 0.015, P=0.001) and peripheral vascular resistance (P=0.031). Seated systolic BP was 7±17mmHg and 9±23mmHg higher and DBP was 6±9mmHg and 3±10mmHg for the GHT and PET groups respectively compared to the NEP and NOP groups. There was no association between hypertension in pregnancy and arterial stiffness or wave reflections in later life.

Conclusion: Our data supports GHT being a distinct phenomenon impacting adversely on blood pressure and peripheral vascular resistance in later life. Further detailed research is required to elucidate discrete mechanisms contributing to altered haemodynamics and the CV risk profile in later life, associated specifically with GHT.