Women who develop gestational hypertension or preeclampsia during pregnancy are at a high risk of developing heart disease over the course of time, suggests a new study published in the Journal of American College of Cardiology.¹

In this study supported by the National Institutes of Health (NIH), researchers examined data of more than 60,000 participants in the Nurses Health Study II. Their objective was to investigate the association between hypertensive disorders of pregnancy and subsequent heart disease. 

During the first pregnancy, nearly 10% women became hypertensive during the first pregnancy; 1789 (3%) had gestational hypertension, while 3834 (6.4%) developed preeclampsia. The risk was 3-folds higher in obese women; those with family history of heart disease or stroke were also likely to develop a hypertensive disorder.

The rate of occurrence of cardiovascular disease was 63% higher in women who had gestational hypertension and/or preeclampsia during their first pregnancy compared to women with normotensive pregnancies. Compared to gestational hypertension, the risk of future heart disease was higher for preeclampsia with hazard ratios of 1.41 and 1.72, respectively. Women with established risk factors for cardiovascular diseases were more prone to develop heart disease; the risk was 57% in women with preeclampsia, while it was 84% in women with gestational hypertension.

Women with preeclampsia were more prone to have an acute coronary artery event, such as a heart attack as early as a decade after the first pregnancy. Strokes were more common in women with gestational hypertension about three decades after the first pregnancy. The biggest contributor to the elevated CV risk in women who had gestational hypertension (81%) and preeclampsia (48%) was chronic hypertension.

Women with a history of hypertensive disorders during pregnancy therefore should be regularly followed up and screened for chronic hypertension, type 2 diabetes, high cholesterol and overweight/obesity after pregnancy. They should also be educated about their increased risk of heart disease and adopt a heart-friendly lifestyle.

Reference

1. Stuart J, et al. Cardiovascular risk factors mediate the long-term maternal risk associated with hypertensive disorders of pregnancy. J Am Coll Cardiol. 2022 May;79(19):1901-1913. https://doi.org/10.1016/j.jacc.2022.03.335.