Long-term monitoring needed after hypertension in pregnancy
medwireNews: Women who develop hypertensive disorders of pregnancy (HDP) are at increased risk for developing hypertension later in life, show findings from a large observational study.
“This study adds to the evidence that a woman's pregnancy history is important when assessing her future risk of [cardiovascular disease],” say study author Joanne Lind (University of Western Sydney, Australia) and co-workers.
“Women who experience HDP should be closely monitored for cardiovascular risk factors, including blood pressure, hyperglycaemia and hyperlipidaemia in the years following pregnancy.”
The analysis involved 71,819 women from the Australian 45 and Up Study, all of whom had given birth between the ages of 18 and 45 years. Of the 10.7% who reported having had HDP, 42.0% were receiving current treatment for hypertension, compared with 16.6% of those whose pregnancies were not complicated by hypertension.
After accounting for confounders including body mass index (BMI), physical activity, and family history of blood pressure, women who were younger than 58 years at the time of the study had a 3.79-fold increased likelihood for hypertension if they reported HDP, while older women had a 2.83-fold increased risk.
Among women who did develop hypertension, the age at diagnosis was significantly younger for those who had HDP than for those who did not, at 45.6 versus 54.8 years.
Having had HDP also conferred a significantly increased risk for stroke, in both age groups, the researchers report in BMJ Open.
The risk for hypertension and stroke associated with hypertensive pregnancy complications was particularly marked among women with an increased BMI. Among women younger than 58 years who reported HDP, the likelihood for having hypertension relative to other women was elevated 4.55-fold if their BMI was below 25 but 12.48-fold if they had a higher BMI. The corresponding increases for older women were 2.94-fold and 5.16-fold.
For stroke, the risk was significantly increased only among women who had both a history of hypertensive pregnancy complications and an increased BMI.
“Women should be encouraged to maintain a healthy weight, particularly if they experience HDP,” say Lind et al.
medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013
By Eleanor McDermid, Senior medwireNews Reporter