How soon does the risk of hypertension increase after delivery?

  • BMJ

  • from Sarfaroj Khan
  • Clinical Summaries
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Takeaway

  • The risk of hypertension associated with hypertensive disorders of pregnancy is high immediately after an affected pregnancy and persists for more than 20 y.

Why this matters

  • Hypertensive disorders of pregnancy (pre-eclampsia; eclampsia; haemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome; and gestational hypertension) affect up to 10% of pregnancies.

Key results

  • Compared with 4% of women with normotensive first pregnancies in their 20s, 14% of women with a hypertensive disorder of pregnancy in a first pregnancy developed hypertension in the first-decade post partum.
  • The corresponding percentages for women with a first pregnancy in their 40s were 11% and 32%, respectively.
  • The rates of post-pregnancy hypertension were 12-fold to 25-fold higher in women with a hypertensive disorder of pregnancy than in women with a normotensive pregnancy.
  • The rates were 3 to 10-fold higher in the decade after delivery and remained twice as high even 20 or more years later.

Study design

  • 482972 women with no hypertension with a first live birth or stillbirth between 1995 and 2012 were included for cumulative incidence analyses.
  • 1025118 women with at least one live birth or stillbirth between 1978 and 2012 were included for Cox regression analyses.
  • Funding: Danish Council for Independent Research, Danish Heart Association.