Abstract

Objective: The objective of the study is to determine frequency of history of hypertensive disorders of pregnancy (HDP) in patients presenting with acute coronary syndromes (ACS) and secondly to evaluate for the prevalence and concomitant association with hypertension, diabetes mellitus, chronic kidney disease (CKD) and cerebrovascular disease (stroke/TIA) in the above said patients. Methods: A cross sectional comparative study was conducted on 654 consecutive female patients presenting with ACS admitted to National Institute of Cardiovascular Diseases, Karachi between May to September 2013. A comprehensive questionnaire including details of obstetric history, history of HDP, ACS, cardiovascular risk factors and existing hypertension (HTN), diabetes mellitus and CKD was obtained. Patients with history of HDP (group 1) were compared with patients without history of HDP (group 2). Results: 654 female patients with ACS with mean age 55.5 ± 10.34 were included. 184 (28%) patients reported having history of HDP, i.e., history of gestational HTN, chronic HTN, pre-eclampsia/eclampsia was noted in 10.8%, 13.4% and 3.8%, respectively. Means of patient age, maternal age at 1st pregnancy and development of ACS (in years) after last pregnancy in patients with and without history of HDP were 53.8 ± 10.29 versus 56.8 ± 11.85 (p=0.003), 21.0 ± 5.89 versus 19.9 ± 5.39 (p=0.028) and 18.6 ± 8.0 versus 22.0 ± 10.0 (p=0.001), respectively. Existing hypertension in patients with history of HDP and without history of HDP were 88.0% versus 80.2% (p=0.018). Conclusion: History of HDP was present in almost one third of female patients presenting with ACS. Mean patient age, development of ACS (in years) after last pregnancy was less in patients with history of HDP. Existing hypertension was more frequent in this patient group.

Keywords: Hypertension; Pregnancy; Acute coronary syndrome