- Women with any hypertensive disorders of pregnancy (HDP), especially pre-term pre-eclampsia are at an increased risk for all cardiovascular (CV) disorders and chronic hypertension.
- The effect was apparent within 1 year of the first index pregnancy.
Why this matters
- Findings suggest that the diagnosis of HDP can be used as a natural screening tool to detect women at higher risk for CV events.
- 1,899,150 unique pregnancies from 1,303,365 women were identified using the Clinical Practice Research Datalink (CPRD) and Hospital Episodes Statistics (HES) database.
- Funding: The National Institute for Health Research Professorship.
- After a median follow-up of 9.25 (interquartile range, 5.53-13.78) years, 18,624 first incident and 21,798 total any type of CV events were reported.
- Of 18,624 first CV events, 12,129 (65.12%) occurred in women
- Compared with women without pre-eclampsia, women who had 1 or more pregnancies affected by pre-eclampsia were at an increased risk for:
- stroke (HR, 1.9; 95% CI, 1.53-2.35),
- cardiac atherosclerotic events (HR, 1.67; 95% CI, 1.54-1.81),
- peripheral events (HR, 1.82; 95% CI, 1.34-2.46),
- heart failure (HR, 2.13; 95% CI, 1.64-2.76),
- atrial fibrillation (HR, 1.73; 95% CI, 1.38-2.16),
- CV deaths (HR, 2.12; 95% CI, 1.49-2.99) and for
- chronic hypertension (HR, 4.47; 95% CI, 4.32-4.62).
- Similar patterns of association were observed for HDP, while pre-term pre-eclampsia showed slightly further elevated risks.
- Differences in cumulative incidence of any CV events according to pre-eclampsia status were apparent within 1 year of the first index pregnancy.
- Possible risk for residual confounding.