Can we predict CVD risk after diagnosis of HDP?

  • J Obstet Gynaecol Can

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Current risk assessment tools may underestimate lifelong cardiovascular disease (CVD) risk in women with hypertensive disorders of pregnancy (HDP).

Why this matters

  • Accurate female-specific CVD risk prediction tools needed.
  • 80% of CVDs could be avoided with pharmacotherapy and lifestyle modification.

Key results

  • Using the 10-year modified Framingham Risk Score (FRS), no difference in eligibility for statin treatment in women with HDP and controls.
  • Using the 30-year Risk Score, 12.2% HDP vs 1.7% controls (P<.001 eligible for statin treatment.>
  • Using the Lifetime Risk Score, 49.2% HDP vs 14.3% controls (P<.0001 eligible for statin treatment.>

Study design

  • Prospective cohort study.
  • Cohort identified from the Maternal Health Clinic (MHC) and the Pre-Eclampsia New Emerging Team (PE-NET).
  • 2016 Canadian Cardiovascular Society guidelines used to estimate CVD risk and eligibility for pharmacologic treatment of lipid levels among women with recent HDP:
    • Women from MHC were assessed at 6 months postpartum;
    • Women from the PE-NET study were assessed at 1 year postpartum.
  • Women from MHC and PE-NET with HDP (n=379) compared with controls from PE-NET (n=131).
  • Funding: None disclosed.

Limitations

  • None of the established CVD risk predicting tools have been validated for young women.
  • Women not followed prospectively until diagnosis of CVD.