A predictive risk score incorporating clinical variables identified chronic hypertension risk after hypertensive disorders of pregnancy with 66% sensitivity and 80% specificity.
Cohort (n=336)
No
A novel clinical risk score incorporating factors like BMI and prior gestational hypertension can identify women at high risk of developing chronic hypertension after hypertensive disorders of pregnancy.
Effect estimate: AUC 0.23
Abstract Background Hypertensive disorders during pregnancy (HDP) are known to increase the risk of developing chronic hypertension (CH) later in life. Identifying patients at higher risk of CH is essential for early risk stratification and targeted prevention strategies. This study aims to develop a predictive score for chronic hypertension in patients with HDP based on a prospective cohort. Methods We analyzed a prospective registry of 336 women consecutively diagnosed with HDP, including gestational hypertension, preeclampsia, and eclampsia in one health center from july 2019 to july 2024. Baseline clinical and laboratory data were collected and CH was defined as persistently elevated blood pressure beyond 3 months postpartum. Logistic regression was used to identify independent predictors of CH. Model performance was assessed using the area under the receiver operating characteristic (ROC) curve (AUC), and an optimal probability threshold was determined using Youden’s index. A risk score was developed based on the identified predictors. Results After follow-up, 14% (n=47) of patients developed CH. Independent predictors of CH included body mass index, gestational hypertension in previous pregnancy, late preeclampsia, use of two drugs for control of blood pressure, and intergenic period between pregnancies, all of which remained significant after multivariable adjustment. The predictive model showed good discrimination (AUC = 0.23). Using an optimal probability threshold of 0.23, the model achieved a sensitivity of 66% and a specificity of 80%. A simplified risk score was derived, allowing for clinical application. Conclusions We identified key independent predictors of CH after HDP and developed a risk score for early identification of high-risk women. This tool may aid in postpartum risk stratification and guide targeted interventions to prevent long-term cardiovascular complications. Further validation in external cohorts is warranted.ROC Curve
Correa-Sadouet et al. (Sat,) conducted a cohort in Hypertensive disorders during pregnancy (n=336). Predictive risk score was evaluated on Chronic hypertension (persistently elevated blood pressure beyond 3 months postpartum) (AUC 0.23). A predictive risk score incorporating clinical variables identified chronic hypertension risk after hypertensive disorders of pregnancy with 66% sensitivity and 80% specificity.