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. 2022 Sep 14;43(35):3352-3361.
doi: 10.1093/eurheartj/ehab686.

Hypertensive disorders of pregnancy and onset of chronic hypertension in France: the nationwide CONCEPTION study

Pauline Boucheron  1 , Grégory Lailler  1 , Elodie Moutengou  1 , Nolwenn Regnault  1 , Amélie Gabet  1 , Catherine Deneux-Tharaux  2   3 , Sandrine Kretz  4 , Clémence Grave  1 , Claire Mounier-Vehier  5 , Vassilis Tsatsaris  3   6 , Geneviève Plu-Bureau  2   3   7 , Jacques Blacher  3   4 , Valérie Olié  1
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Hypertensive disorders of pregnancy and onset of chronic hypertension in France: the nationwide CONCEPTION study

Pauline Boucheron et al. Eur Heart J. .

Abstract

Aims: Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and foetal morbidity and mortality. We aimed to estimate the impact of HDP on the onset of chronic hypertension in primiparous women in the first years following childbirth.

Methods and results: This nationwide cohort study used data from the French National Health Data System (SNDS). All eligible primiparous women without pre-existing chronic hypertension who delivered between 2010 and 2018 were included. Women were followed up from six weeks post-partum until onset of hypertension, a cardiovascular event, death, or the study end date (31 December 2018). The main outcome was a diagnosis of chronic hypertension. We used Cox models to estimate hazard ratios (HRs) of chronic hypertension for all types of HDP. Overall, 2 663 573 women were included with a mean follow-up time of 3.0 years. Among them, 180 063 (6.73%) had an HDP. Specifically 66 260 (2.16%) had pre-eclampsia (PE) and 113 803 (4.27%) had gestational hypertension (GH). Compared with women who had no HDP, the fully adjusted HRs of chronic hypertension were 6.03 [95% confidence interval (CI) 5.89-6.17] for GH, 8.10 (95% CI 7.88-8.33) for PE (all sorts), 12.95 (95% CI 12.29-13.65) for early PE, 9.90 (95% CI 9.53-10.28) for severe PE, and 13.17 (95% CI 12.74-13.60) for PE following GH. Hypertensive disorders of pregnancy exposure duration was an additional risk factor of chronic hypertension for all PE subgroups. Women with HDP consulted a general practitioner or cardiologist more frequently and earlier.

Conclusion: Hypertensive disorders of pregnancy exposure greatly increased the risk of chronic hypertension in the first years following delivery.

Keywords: Blood pressure; Epidemiology; Gestational hypertension; Hypertension; Pre-eclampsia; Pregnancy complication.

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Conflict of interest statement

Conflict of interest: S.K. reports, outside the submitted work, non-financial support from Lilly France, Novonordisk, Novartis Pharma, Roche diabetes care, Lifescan, Abbott France, Sanofi, ViiV Healthcare, Servier, Becton Dickinson and personal fees from Icomed, Pascaleo, BT3SI, M3global research. C.M.-V. reports, outside the submitted work, personal fees and non-financial support from Servier, Lundbeck, Astrazeneca, MSD, and Boehringer. J.B. reports, outside the submitted work, personal fees from Abbott, Bayer, Bottu, Ferring, Steripharma, Kantar, Teriak, personal fees and non-financial support from Pfizer, Quantum Genomics, personal fees from Sanofi and Servier. All other authors declared no conflict of interest.

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