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Hypertensive Disorders of Pregnancy & CVD Risk

Ann Intern Med; ePub 2018 Jul 3; Stuart, et al

Women with hypertensive disorders of pregnancy (HDP) in their first pregnancy had increased rates of chronic hypertension, type 2 diabetes mellitus (T2DM), and hypercholesterolemia that persisted for decades, a new study found. The observational cohort study sought to identify associations between HDP and maternal CVD risk factors and chart the trajectory of risk factor development after pregnancy. 58,671 parous women from the Nurses’ Health Study II (NHS II) who did not have CVD or risk factors of interest at baseline were included. Women were followed for self-reported physician diagnosis of chronic hypertension and hypercholesterolemia and confirmed T2DM from their first birth through 2013. Mean follow-up ranged from 25 to 32 years across these end points. Researchers found:

  • Women with gestational hypertension (2.9%) or preeclampsia (6.3%) in their first pregnancy had increased rates of chronic hypertension, T2DM, and hypercholesterolemia compared with women who were normotensive during pregnancy.
  • The relative risk for chronic hypertension was strongest within 5 years after first birth.
  • Recurrence of HDP further elevated risks for all end points.

Citation:

Stuart JJ, Tanz LJ, Missmer SA, et al. Hypertensive disorders of pregnancy and maternal cardiovascular disease risk factor development: An observational cohort study. [Published online ahead of print July 3, 2018]. Ann Intern Med. doi:10.7326/M17-2740.