Hypertension risk postpregnancy high among women with heart disease

Women with heart disease are at increased risk of developing hypertension in the decades after pregnancy compared with those without heart disease, as reported in a retrospective study.

For the study, researchers looked at the medical records of 832 women who had been pregnant with congenital or acquired heart disease and 1,664 who had been pregnant without heart disease (control). These two groups of participants were matched based on demographics and baseline risk for hypertension at the time of the index pregnancy.

The median age at the time of the index delivery was 30 years in both groups. There was no significant difference observed in the participant characteristics at the time of the index birth other than a greater proportion of women in the heart disease group who had a Charlson score ≥1, had renal disease before pregnancy, delivered at a tertiary care centre, had a baby born with congenital cardiac defect, or experienced any nonhypertension‐related obstetric complication.

The cumulative incidence of hypertension over 20 years was 24 percent in the heart disease group vs 14 percent in the control group, with the median follow‐up time at hypertension diagnosis being 8.1 years in the heart disease group.

Heart disease was associated with an 81-percent increase in the risk of hypertension (hazard ratio [HR], 1.81, 95 percent confidence interval [CI], 1.44–2.27). This risk increase was consistently observed among women with ischaemic heart disease, those with left‐sided valve disease, those with cardiomyopathy, and those with congenital heart disease.

Pregnancy risk prediction methods were able to further stratify the risk of new hypertension. Of note, new hypertension correlated with an increased rate of subsequent death or cardiovascular events (HR, 1.54, 95 percent CI, 1.05–2.25).

The findings underscore the importance of systematic and lifelong surveillance among women who are pregnant with heart disease.