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

ABSTRACT Objective To develop a prediction model for the development of hypertension in the decade following pre‐eclampsia in women who were normotensive shortly after pregnancy. Methods This was a longitudinal cohort study of formerly pre‐eclamptic women attending a university hospital in The Netherlands between 1996 and 2019. We developed a prediction model for incident hypertension using multivariable logistic regression analysis. The model was validated internally using bootstrapping techniques. Results Of 259 women, 185 (71%) were normotensive at the first cardiovascular assessment, at a median of 10 (interquartile range (IQR), 6–24) months after a pre‐eclamptic pregnancy, of whom 49 (26%) had developed hypertension by the second visit, at a median of 11 (IQR, 6–14) 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 good‐to‐excellent discriminative ability, with an area under the receiver‐operating‐characteristics curve (AUC) of 0.82 (95% CI, 0.75–0.89) and an optimism‐corrected AUC of 0.80. The sensitivity and specificity of our model to predict hypertension were 98% and 34%, respectively, and positive and negative predictive values were 35% and 98%, respectively. Conclusions Based on five variables, we developed a good‐to‐excellent predictive tool to identify incident hypertension following pre‐eclampsia in women who were normotensive shortly after pregnancy. After external validation, this model could have considerable clinical utility in tackling the cardiovascular legacy of pre‐eclampsia. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.