Pre-eclampsia bears increased hazard of heart failure

Women with pre-eclampsia are at higher risk of developing heart failure, a study suggests.

Researchers looked at 508,422 women, among whom 46,084 (9.1 percent) experienced hypertensive disorders of pregnancy (HDP). In the HDP group, 8,827 women (1.7 percent) had gestational hypertension (GH) and 24,326 (4.8 percent) had pre-eclampsia in the first birth. Women with GH and pre-eclampsia were more likely to have pregnancy complications (small for gestational age and preterm delivery) compared with those who had no HDP.

Over a median 11.8 years, heart failure occurred in 565 women: 499 in the no HDP group (incidence rate, 8.48 per 10,000 woman-years), 15 in the GH group (incidence rate, 13.05 per 10,000 woman-years), and 51 in the pre-eclampsia group (incidence rate, 17.90 per 10,000 woman-years).

Multivariable Cox proportional hazards analysis showed that HDP was associated with an increased risk of heart failure. But the risk increase was only significant for pre-eclampsia (hazard ratio [HR], 2.00, 95 percent confidence interval [CI], 1.50–2.68; p<0.001) and not GH (HR, 1.41, 95 percent CI, 0.84–2.35; p=0.19).

The heart failure risk was not modified by concurrent small-for-gestational-age or preterm delivery complications (p=0.42). Furthermore, the risk was most pronounced among women whose only lifetime birth was complicated by pre-eclampsia and those with recurrent pre-eclampsia.

Additional studies are needed to elucidate causal mechanisms.