Hypertensive Disorders of Pregnancy Associated With Long-Term CV Risk

Hypertensive disorders of pregnancy may be associated with accelerated cardiovascular aging and more diverse cardiovascular conditions, including valvular heart disease, according to research published Nov. 11 in the Journal of the American College of Cardiology, which will be presented at AHA 2019 in Philadelphia, PA.

Michael C. Honigberg, MD, et al., examined the long-term incidence of diverse cardiovascular conditions among middle-aged women in the UK Biobank with and without prior hypertensive disorders of pregnancy. Noninvasive arterial stiffness measurement was performed in a subset of women, and causal mediation analyses estimated the contribution of conventional risk factors to observed associations.

Results showed that of the 220,024 women, 2,808 (1.3 percent) had prior hypertensive disorders of pregnancy. Women with hypertensive disorders of pregnancy were found to have signs of elevated arterial stiffness and greater prevalence of chronic hypertension compared to women without.

Furthermore, the authors found that hypertensive disorder of pregnancy was associated with shorter time to first incident cardiovascular diagnosis and increased hazards of coronary artery disease (CAD), heart failure, aortic stenosis and mitral regurgitation. In causal mediation analyses, chronic hypertension explained 64 percent of hypertensive disorder of pregnancy and its association with CAD, as well as 49 percent of its association with heart failure.

Moving forward, the authors conclude that, "further research is needed to elucidate the mechanisms linking hypertensive pregnancy complications with long-term cardiovascular risk and to determine optimal strategies for screening, prevention and management."

Clinical Topics: Heart Failure and Cardiomyopathies, Prevention, Valvular Heart Disease, Atherosclerotic Disease (CAD/PAD), Acute Heart Failure, Hypertension, Mitral Regurgitation

Keywords: AHA Annual Scientific Sessions, AHA19, Risk Factors, Cardiovascular Diseases, Coronary Artery Disease, Vascular Stiffness, Mitral Valve Insufficiency, Biological Specimen Banks, Hypertension, Heart Valve Diseases, Heart Failure, Aortic Valve Stenosis, Pregnancy Complications


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