Excess Risk in Women with Hypertension During Pregnancy Linked with Risk Factors

A new study published in JAMA Cardiology sought to quantify what excess risk for cardiovascular disease in women with a history of hypertension during pregnancy may be associated may be associated with typical cardiovascular risk factors.

“Women with a history of hypertensive disorders of pregnancy have higher risk of cardiovascular disease,” the researchers wrote in the abstract. “It is not known how much of the excess cardiovascular disease risk in women with a history of hypertension during pregnancy is associated with conventional cardiovascular risk factors.”

In this study, the risk of excess CVD in women with history of HDP was associated with conventional cardiovascular risk factors, indicating that these risk factors are important targets for cardiovascular prevention in these women. https://t.co/7BH3HVOEd2

— JAMA Cardiology (@JAMACardio) June 14, 2019

This prospective analysis of the Nord-Trøndelag Health Study looked at data from 31,364 Norwegian women who had experienced one or more pregnancies before age 40. Their data were linked to validated hospital records, the Cause of Death Registry, and the Medical Birth Registry of Norway. A total of 7,399 participants were excluded form the analysis based on selected pregnancy characteristics. The main study outcome was the hazard ratios for the link between hypertension during pregnancy and cardiovascular disease as determined using Cox proportional hazards models. An inverse odds ratio weighting approach was used to quantify the proportion of excess risk associated with conventional cardiovascular risk factors.

Links to Traditional Hypertension Risk Factors

According to the study results, of 23,885 parous women, 21,766 had only normotensive pregnancies. A total of 2,199 experienced hypertension during pregnancy, and women between 40 and 70 years of age with a history of hypertension during pregnancy had an increased risk for cardiovascular disease compared with women with normotensive pregnancies (HR=1.57; 95% CI, 1.32 to 1.87). This effect did not apply to older age, however (β=0.98; 95% CI, 0.96 to 1.00; P for interaction by age=0.01). The authors also reported that blood pressure and body mass index were associated with 77% of the excess risk of cardiovascular disease in the women with histories of hypertension during pregnancy.

“The association of conventional risk factors, in particular blood pressure and body mass index, with the development of cardiovascular disease in women with history of hypertensive pregnancy disorders indicate that preventive efforts aimed at decreasing the levels of these risk factors could reduce cardiovascular risk in women with history of hypertensive pregnancy disorders,” the researchers concluded.

Cardiovascular Risk Factors and Disease After Hypertensive Disorders of Pregnancy https://t.co/vm3gfjZ5Fg@JAMACardio #CardioObstetrics pic.twitter.com/AhCLFK2Gkw

— Minnow Walsh, MD, MACC (@MinnowWalsh) June 16, 2019

Great study showing that the excess risks of cardiovascular disease in women with hypertensive disorders during pregnancy are particularly caused by conventional risk factors BMI and blood pressure.https://t.co/WKaBjatkcB

— Tim Korevaar (@TimKorevaar) June 15, 2019

#WTMFY:
1) High blood pressure during pregnancy increases risk of heart disease later on.
2) Blood pressure and BMI matter most for these women.https://t.co/rFbpWDOAOX via @JAMACardio @WomenAs1

— Heartbeat (@heartbeat) June 15, 2019