{"id":"46097","type":"article","url":"https://hartvaat.nl/2026/04/07/voor-het-voorspellen-van-hypertensie-na-de-zwangerschap-telt-de-obstetrische-voo/","title":"Voor het voorspellen van hypertensie na de zwangerschap telt de obstetrische voorgeschiedenis zwaarder dan biomarkers","title_en":"Obstetric History Versus Biomarkers: Hypertension Risk Up to 15 Years Postpartum","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Hypertension","doi":"https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25552","source_url":"https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25552","authors":["Tooba Anwer"],"significance":6,"published":"2026-07-25","source_date":"2026-04-07","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/hypertensie-en-zwangerschap/","https://hartvaat.nl/kennis/hypertensie/therapietrouw-hypertensie/"],"congress":"","summary_en":"The sFlt-1/PlGF ratio predicts severe preeclampsia, but its link to long-term hypertension was unclear. In this retrospective cohort (LIFECODES biobank, 993 participants; sFlt-1 and PlGF measured in the second half of pregnancy), 29% developed stage 1 and 17% stage 2 hypertension over 15 years. A history of preeclampsia or gestational hypertension was strongly associated with later hypertension (adjusted HR 2.17 and 3.50, respectively), whereas the sFlt-1/PlGF ratio showed no association. PlGF levels were, however, lower in women who later developed hypertension. For long-term prediction of hypertension, obstetric history is thus more informative than pregnancy biomarkers — a simple basis for follow-up after a hypertensive pregnancy.","created":"2026-07-03T20:27:19Z","updated":"2026-07-04T19:26:44Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De sFlt-1/PlGF-ratio voorspelt ernstige pre-eclampsie, maar het verband met hypertensie op lange termijn was onduidelijk. In deze retrospectieve cohortstudie (LIFECODES-biobank, 993 deelnemers; sFlt-1 en PlGF gemeten in de tweede helft van de zwangerschap) ontwikkelde over 15 jaar 29% stadium 1- en 17% stadium 2-hypertensie. Een voorgeschiedenis van pre-eclampsie of zwangerschapshypertensie was sterk geassocieerd met latere hypertensie (gecorrigeerde HR respectievelijk 2,17 en 3,50), terwijl de sFlt-1/PlGF-ratio géén verband toonde. Wel waren de PlGF-waarden lager bij vrouwen die later hypertensie kregen. Voor de langetermijnvoorspelling van hypertensie is de obstetrische voorgeschiedenis dus informatiever dan de zwangerschapsbiomarkers — een eenvoudig aanknopingspunt voor follow-up na een hypertensieve zwangerschap.","abstract_original":"BACKGROUND:sFlt-1 (serum soluble fms-like tyrosine kinase-1) to PlGF (placental growth factor) can be used to predict the development of severe preeclampsia. The association between sFlt-1/PlGF during pregnancy and long-term risk of hypertension is unclear.METHODS:This is a retrospective cohort study of patients enrolled from 2006 to 2008 in the ongoing LIFECODES biobank. Mean sFlt-1 and PlGF levels were collected in the second half of pregnancy. Electronic medical record review identified those who developed hypertension over 15 year follow-up. Adjusted Cox proportional hazard models were used to estimate hazard ratios and 95% CI for the time to diagnosis of hypertension.RESULTS:Of the n=993 participants, n=260 (29.18%) were diagnosed with stage 1 and n=169 (17.0%) were diagnosed with stage 2 hypertension. One hundred thirteen of the participants in the database had a diagnosis of gestational hypertension or preeclampsia. A history of preeclampsia or a history of gestational hypertension was both significantly associated with developing hypertension later in life, with adjusted hazard ratios of 2.17 (95% CI, 1.44–3.28) and 3.50 (95% CI, 2.21–5.54), respectively. We observed no significant association between the hazard of developing hypertension and sFlt-1/PlGF. However, mean PlGF levels in those who remained normotensive in the follow-up were significantly higher, 546.7 pg/mL (SD=369.5), compared with those who developed hypertension, 513.7 pg/mL (SD=389.9;P=0.008).CONCLUSIONS:A history of hypertensive disease of pregnancy was significantly associated with the hazard of developing HTN later in life, while elevated sFlt-1/PlGF levels were not. PlGF levels alone were significantly lower in those who developed hypertension later."}