Hypertensive disorder in pregnancy and later cardiovascular risk

January 01, 0001

Hypertensive disorder in pregnancy and later cardiovascular risk

Hypertensive disorder in pregnancy, such as preeclampsia and gestational hypertension, have been linked with an increased risk for cardiovascular disease later in life. These Norwegian and British researchers tested whether the effect can be attributed to factors that operate in pregnancy or to prepregnancy risk factors. They used longitudinal data from 2 consecutive waves of a population-based study in Norway, the Nord-Trøndelag Health Study (HUNT), along with data from the Medical Birth Registry of Norway. They identified 3225 women from the studies with a singleton birth who had recorded measurements of blood pressure, serum lipids, and body mass index.

The researchers report: "The crude results showed that women who experienced preeclampsia or gestational hypertension in pregnancy had substantially higher levels of body mass index and systolic and diastolic blood pressures and unfavorable lipids compared with other women. However, after adjustment for prepregnancy measurements, the difference in body mass index was attenuated by >65%, and the difference in blood pressure was attenuated by 50%. In relation to high-density lipoprotein cholesterol and triglycerides, differences between the groups were attenuated by 40% and 72%, respectively."

The researchers concluded: "These results suggest that the positive association of preeclampsia and gestational hypertension with postpregnancy cardiovascular risk factors may be due largely to shared prepregnancy risk factors rather than reflecting a direct influence of the hypertensive disorder in pregnancy."

This study suggests that the link between hypertensive disorders in pregnancy and subsequent cardiovascular risk is in large part attributable to prepregnancy risk factors.

For the full abstract, click here.

Circulation 122(6):579-584, 10 August 2010 © 2010 American Heart Association, Inc.
Hypertension in Pregnancy and Later Cardiovascular Risk: Common Antecedents?. Pål R. Romundstad, Elisabeth B. Magnussen, George Davey Smith, Lars J. Vatten. Correspondence to Pal Richard Romundstad: [email protected]

Category: K. Circulatory, W. Pregnancy, Family Planning. Keywords: gestational hypertension, preeclampsia, cardiovascular risk, antecedents, pregnancy, longitudinal study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 31 August 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.