Pregnancy‐induced hypertension is increasingly recognized as a risk factor for subsequent cardiovascular disease in women. In particular, preeclampsia, characterized by Gestational hypertension with proteinuria, is associated with a markedly higher CVD risk and has been incorporated in the American Heart Association guidelines for the assessment of CVD risk in women.
However, studies of different kinds of cardiovascular diseases, such as heart disease and heart failure, have found mixed results.
A new study reviewed meta-analysis of 21 studies involving a total of 3.6 million women, 128,000 of who previously had gestational hypertension.
Scientists found that women who experienced high blood pressure during their first pregnancy were at a 45% higher risk of overall cardiovascular disease and 46% higher risk of coronary heart disease compared to women who did not have high blood pressure in pregnancy. Women with one or more pregnancies affected by high blood pressure were at 81% higher risk of cardiovascular disease, 83% higher risk of coronary heart disease, and a 77% higher risk of heart failure.
Senior author Dr. Clare Oliver-Williams from the Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge said, “When we looked at all the available research, the answer was clear: women who develop high blood pressure during pregnancy – even when it doesn’t develop into preeclampsia – are more likely to develop several different kinds of cardiovascular disease.”
This study adds another evidence to the link between pregnancy and subsequent risk of cardiovascular events. Recurrent miscarriages, preterm birth, fetal growth restriction, and preeclampsia have all previously been linked with a higher risk of heart disease.
Scientists noted, “it is not entirely clear why gestational hypertension is associated with heart disease in later life. However, they suggest it may be that high blood pressure in pregnancy causes lasting damage that contributes to cardiovascular disease. Alternatively, women who develop gestational hypertension may have a pre-existing susceptibility to cardiovascular disease that is revealed due to the large demands that pregnancy places upon women’s bodies.”
Dr. Oliver-Williams added: “It’s important that women know that it isn’t their fault that they developed high blood pressure in pregnancy, and developing heart disease isn’t a foregone conclusion. Women who have experienced gestational hypertension may have been dealt a tough hand, but it’s how they play those cards that matters the most. Small positive changes can help. They can be as simple as eating more fruit and vegetables, small bouts of regular exercise, and finding time to unwind if that’s possible with kids around.”
Dr. Oliver-Williams is a Junior Research Fellow at Homerton College, University of Cambridge. The Cardiovascular Epidemiology Unit is supported by the British Heart Foundation and the Medical Research Council.
- Lo, CCW & Lo, ACQ, et al. Future cardiovascular disease risk for women with gestational hypertension: a systematic review and meta-analysis. JAHA; 24 Jun 2020; DOI: 10.1161/JAHA.119.013991