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Comparative Study
. 2010 Apr;28(4):826-33.
doi: 10.1097/HJH.0b013e328335c29a.

Hypertension in pregnancy as a risk factor for cardiovascular disease later in life

Vesna D Garovic  1 , Kent R Bailey, Eric Boerwinkle, Steven C Hunt, Alan B Weder, David Curb, Thomas H Mosley Jr, Heather J Wiste, Stephen T Turner
Affiliations
Comparative Study

Hypertension in pregnancy as a risk factor for cardiovascular disease later in life

Vesna D Garovic et al. J Hypertens. 2010 Apr.

Abstract

Objective: The association between hypertension in pregnancy and future cardiovascular disease (CVD) increasingly is recognized. We aimed to assess the role of hypertension in pregnancy as an independent risk factor for hypertension, coronary heart disease (CHD), and stroke later in life.

Methods: Women who participated in the Phase 2 (2000-2004) Family Blood Pressure Program study (n = 4782) were categorized into women with no history of pregnancy lasting more than 6 months (n = 718), women with no history of hypertension in pregnancy (n = 3421), and women with a history of hypertension in at least one pregnancy (n = 643). We used Kaplan-Meier and Cox proportional hazard models to estimate and contrast the risks of subsequent diagnoses of hypertension, CHD, and stroke among the groups.

Results: Women with a history of hypertension in pregnancy, compared with those without such a history, were at increased risks for the subsequent diagnoses of hypertension (50% hypertensive at the age 53 vs. 60, P < 0.001), CHD (14% estimated event rate vs. 11%, P = 0.009), and stroke (12% estimated event rate vs. 5%, P < 0.001). The increased risk for subsequent hypertension remained significant after controlling for race, family history of CVD, smoking, dyslipidemia, and diabetes mellitus, with an adjusted hazard ratio of 1.88 [95% confidence interval (CI) 1.49-2.39, P < 0.001]. After controlling for traditional risk factors, including subsequent hypertension, the increased risk for stroke remained statistically significant (hazard ratio 2.10, 95% CI 1.19-3.71, P = 0.01), but not for CHD.

Conclusion: Hypertension in pregnancy may be an independent risk factor for subsequent diagnoses of hypertension and stroke.

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Conflict of interest statement

There are no conflicts of interest.

The following investigators are associated with the Family Blood Pressure Program:

GenNet Network: Alan B. Weder (Network Director), Lillian Gleiberman (Network Coordinator), Anne E. Kwitek, Aravinda Chakravarti, Richard S. Cooper, Carolina Delgado, Howard J. Jacob, and Nicholas J. Schork.

GENOA Network: Eric Boerwinkle (Network Director), Tom Mosley, Alanna Morrison, Kathy Klos, Craig Hanis, Sharon Kardia, and Stephen Turner.

HyperGEN Network: Steven C. Hunt (Network Director), Janet Hood, Donna Arnett, John H. Eckfeldt, R. Curtis Ellison, Chi Gu, Gerardo Heiss, Paul Hopkins, Aldi T. Kraja, Jean-Marc Lalouel, Mark Leppert, Albert Oberman, Michael A. Province, D.C. Rao, Treva Rice, and Robert Weiss.

SAPPHIRe Network: David Curb (Network Director), David Cox, Timothy Donlon, Victor Dzau, John Grove, Kamal Masaki, Richard Myers, Richard Olshen, Richard Pratt, Tom Quertermous, Neil Risch, and Beatriz Rodriguez.

National Heart, Lung, and Blood Institute: Dina Paltoo and Cashell E. Jaquish.

Web Site: http://www.biostat.wustl.edu/fbpp/FBPP.shtml.

Figures

Fig. 1
Fig. 1
Kaplan–Meier plots of the cumulative probability of being free of hypertension (a), coronary heart disease (b), and stroke (c) as a function of age among nulliparous women, those with a history of normotensive pregnancies, and women with a history of either hypertensive or preeclamptic pregnancies. Numbers along the x-axis show the number of women at risk in each age group over time.
See this image and copyright information in PMC

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