Prediction model for hypertension in first decade after pre-eclampsia in initially normotensive women

OBJECTIVE: To develop a prediction model for the development of hypertension in the decade following pre-eclampsia in women who were initially normotensive shortly after pregnancy. METHODS: We conducted a longitudinal cohort study in 259 formerly pre-eclamptic women in a University hospital in The Netherlands. We developed a prediction model using multivariable logistic regression analysis. The model was internally validated with bootstrapping techniques. RESULTS: Of the 259 women, 185 (71%) were normotensive at first visit at a median of 10 months [interquartile range, 6-24] postpartum of which 49 (26%) had developed hypertension at the second visit at a median of 11?years postpartum. The prediction model, based on birth-weight centile, mean arterial pressure, total cholesterol, left ventricular mass index and left ventricular ejection fraction, had a good to excellent discriminative ability of AUC-ROC-curve 0.82 (95% CI, 0.75-0.89) with an optimism corrected AUC of 0.80. Sensitivity and specificity of our model to predict hypertension was 98% and 65%, respectively, and positive and negative predictive values were 50% and 99%, respectively. CONCLUSIONS: Based on five variables, we developed a good-to-excellent performing predictive tool to identify incident hypertension following pre-eclampsia in women that were normotensive shortly after pregnancy. After external validation, this model could have considerable clinical utility in tackling the cardiovascular legacy of pre-eclampsia. This article is protected by copyright. All rights reserved.