JAHA: Hypertension in pregnancy increases the risk of coronary heart disease, stroke and death within five years after delivery

Pre-pregnancy hypertension and hypertensive disorders of pregnancy (Hypertensive disorders of pregnancy, HDP) are the main health risks of maternal morbidity and mortality.

Among them, HDP includes pre-eclampsia, eclampsia, and pregnancy-induced hypertension, which occurs in approximately 10% of pregnancies.

Pregnancy hypertension usually refers to new-onset hypertension that appears after 20 weeks of pregnancy.
Pre-eclampsia refers to new-onset hypertension with proteinuria and/or obvious end-organ dysfunction, and eclampsia is characterized by new-onset hypertension.
Unprovoked seizures.

HDP increases the risk of preterm birth and the risk of complications associated with preterm birth in newborns.

What's more, HDP may also cause maternal stroke, seizures, coagulopathy, renal failure, bleeding and death.

Recent studies have found that HDP is related to long-term morbidity and mortality.

However, previous studies failed to fully consider the impact of potential confounding factors and ethnic factors on the results.

Therefore, researchers such as Angela M.
Malek investigated the relationship between HDP, pre-pregnancy hypertension and the long-term cardiovascular outcomes of pregnant women, especially the relationship with coronary heart disease, stroke, and mortality within 1, 3, and 5 years after delivery.

The results of the study were recently published in JAHA, an authoritative journal in the cardiovascular field.

The study was a retrospective cohort study that included women aged 12 to 49 who were born alive and singletons between 2004 and 2016 (254,491 non-Hispanic whites; 137,784 non-Hispanic blacks; 41,155 Hispanics) .

During the pregnancy of 433 430 women, 2.
3% of women had pre-pregnancy hypertension with HDP, 15.
7% of women had no pre-pregnancy hypertension but HDP, 0.
4% of women had pre-pregnancy hypertension but no HDP, and 81.
6% of women had both Neither situation.A total of 2136 pregnant women died of coronary heart disease, stroke and various causes.

Within 5 years after delivery, compared with no pre-pregnancy hypertension or HDP, both pre-pregnancy hypertension and HDP and all-cause mortality (hazard ratio [HR], 2.
21; 95% CI, 1.
61-3.
03), new coronary heart disease (HR, 3.
79; 95%CI, 3.
09-4.
65) is associated with new-onset stroke (HR, 3.
10; 95%CI, 2.
09-4.
60).

HDP is solely related to all results.

That is to say, women who have both pre-pregnancy hypertension and HDP or only HDP have an increased risk of death, coronary heart disease or stroke within 5 years after delivery.

The association of pre-pregnancy hypertension and HDP with all-cause mortality within 1, 3, and 5 years after delivery, new-onset coronary heart disease, and stroke.
The association between pre-pregnancy hypertension and HDP and all-cause mortality within 5 years after delivery in non-Hispanic blacks and Africans There are racial differences among Hispanic whites, and the association is stronger among blacks (Black HR, 2.
34 [95% CI, 1.
58-3.
47]; White HR, 2.
11 [95% CI, 1.
23-3.
65]; P interaction = 0.
001).

The study shows that HDP is associated with long-term cardiovascular disease and death risks.
Pregnant women with HDP should be observed more closely after delivery and monitored for cardiovascular risk factors. References Malek AM, Wilson DA, Turan TN, Mateus J, Lackland DT, Hunt KJ.
Maternal Coronary Heart Disease, Stroke, and Mortality Within 1, 3, and 5 Years of Delivery Among Women With Hypertensive Disorders of Pregnancy and Pre-Pregnancy Hypertension \[published online ahead of print, 2021 Feb 23\].
_J Am Heart Assoc_.
2021;e018155.
doi:10.
1161/JAHA.
120.
018155 For more information, please click to read the original text to download the Metz Medical APP~