Medical conditions such as hypertension and preeclampsia are associated with an increased risk of cardiovascular disease. A Harvard Medical School study now sheds light on the long-term consequences for affected women.
Dr Jennifer Stuart and her team investigated how hypertensive disorders of pregnancy (HSE) associated with the long-term risk of cardiovascular disease (cardiovascular disease) and other risk factors. HSEs are diseases whose main symptom is hypertension, which mainly include hypertension in pregnancy and preeclampsia.
For their study, the researchers used data from the Nurses’ Health Study II. About 116,000 nurses have taken part in this long-term study since 1989 and have provided important health data over the decades, including pregnancy and cardiovascular disease.
Cardiac health after gestational hypertension and preeclampsia
The research team analyzed data from a total of 60,379 nurses in whom cardiovascular disease and chronic hypertension could be ruled out before the first pregnancy. The data evaluated range from 1989 to 2017.
HSEs significantly increase the risk of cardiovascular disease in old age
One in ten study participants developed HSE during their first pregnancy (6.4% preeclampsia, 3% gestational hypertension). Obese women (BMI> = 30) before the first pregnancy had a three times higher risk of HSE. Approximately 30 years later, 1.8% of all participants experienced a cardiovascular event (e.g. stroke, heart attack).
After preeclampsia in early pregnancy, the risk of heart attack in particular increases in the long term. While gestational hypertension in early pregnancy predominantly increased the risk of stroke.
Women with HSE in their first pregnancy had a 63% higher long-term risk of cardiovascular disease than women with normal blood pressure during pregnancy. Nearly two-thirds of this increased risk of cardiovascular disease can be attributed to the fact that those affected developed chronic hypertension, hypercholesterolemia, type 2 diabetes, or were very overweight in the years after birth.
Prevention of hypertension or preeclampsia after pregnancy is particularly important
The study authors read from their findings that women after HSE should be screened for cardiovascular risk factors (chronic hypertension, hypercholesterolemia, type 2 diabetes, overweight, obesity) and treated. In this way, cardiovascular diseases in old age can be delayed or even prevented.
Those: Jennifer J. Stuart et al, Cardiovascular risk factors mediate long-term maternal risk associated with hypertensive disorders of pregnancy, Journal of the American College of Cardiology (2022). DOI: 10.1016 / j.jacc.2022.03.335