Pre-eclampsia carries increased risk of cardiovascular disorders

Women with hypertensive disorders of pregnancy, especially pre-eclampsia, are at heightened risk of developing cardiovascular disorder and chronic hypertension, with the risk becoming apparent soon after pregnancy, a study has found.

Researchers looked at a UK population-based cohort of 1.3 million women (mean age at delivery, 28 years) with nearly 1.9 million completed pregnancies. A total of 18,624 incident cardiovascular disorders were recorded over the 20-year study period, and 65 percent of these events occurred in women aged <40 years.

Relative to women without hypertension in pregnancy, those who had one or more pregnancies affected by pre-eclampsia were more likely to develop any stroke (hazard ratio [HR], 1.9, 95 percent CI, 1.53–2.35), cardiac atherosclerotic events (HR, 1.67, 1.54–1.81), peripheral events (HR, 1.82, 1.34–2.46), heart failure (HR, 2.13, 1.64–2.76), atrial fibrillation (HR, 1.73, 1.38–2.16), cardiovascular deaths (HR, 2.12, 1.49–2.99) and chronic hypertension (HR, 4.47, 4.32–4.62).

Differences in cumulative incidence curves in the group of women with vs without pre-eclampsia were evident within 1 year of the first index pregnancy. Similar patterns of association were observed for hypertensive disorders of pregnancy, whereas preterm pre-eclampsia was associated with slightly higher risks.

In light of the findings, the researchers suggest that hypertensive disorders of pregnancy be considered as a natural screening tool for cardiovascular events, enabling cardiovascular risk prevention through national initiatives.