Pregnancy-induced hypertension linked to subsequent arrhythmia

Women with pregnancy-induced hypertension (PIH) are at increased risk of developing arrhythmia, but not lethal arrhythmias, within 1 year after delivery, a study reports.

The study used data from the Korea National Health Insurance database and combined with the National Health Screening Examination database. A total of 2,035,684 who underwent a screening test prior to pregnancy were included in the analysis.

There were 37,297 women who developed PIH, while the remaining 1,998,386 had normotensive pregnancy. Women with vs without PIH were older at delivery, more likely to be multiparous, and had caesarean delivery. In terms of prepregnancy baseline characteristics, the PIH group were mostly obese and had higher blood pressure values, serum liver aminotransferase levels, fasting blood glucose, and total cholesterol levels, and were more likely to be smokers.

The primary outcome of significant arrhythmia within 12 months after delivery occurred in 5,029 (0.25 percent) women. The incidence was higher among women with PIH than among those with normotensive pregnancy (0.62 percent vs 0.24 percent). Of note, the PIH group had a markedly higher risk of atrial flutter/fibrillation and atrioventricular block, but not lethal arrhythmias.

Other predictors of arrhythmia development were advanced maternal age and caesarean section. Further analysis showed that the use of magnesium sulphate was associated with a higher risk of arrhythmia.

The findings have important clinical implications, as arrhythmia, especially atrial fibrillation, may largely contribute to increasing the future cardiovascular risk in women with a PIH history.