Women who experience high blood pressure during pregnancy are more likely to develop heart disease and heart failure in later life, according to an international team of researchers.
Between 1-6% of all pregnancies in Western countries are affected by gestational hypertension, or pregnancy-induced hypertension. Clinicians increasingly recognise that women who have had gestational hypertension are more likely to develop cardiovascular disease in later life.
To examine these links further, an international team of researchers conducted a systematic review and meta-analysis of 21 studies involving a total of 3.6 million women, 128,000 of who previously had gestational hypertension. The results are published in the Journal of the American Heart Association.
The researchers found that women who experienced high blood pressure during their first pregnancy were at 45% higher risk of overall cardiovascular disease and 46% higher risk of coronary heart disease compared to women who did not have high blood pressure in pregnancy. Women with one or more pregnancies affected by high blood pressure were at 81% higher risk of cardiovascular disease, 83% higher risk of coronary heart disease and 77% higher risk of heart failure.
“When we looked at all the available research, the answer was clear: women who develop high blood pressure during pregnancy – even when it doesn’t develop into pre-eclampsia – are more likely to develop several different kinds of cardiovascular disease,” said senior author Dr Clare Oliver-Williams from the Cardiovascular Epidemiology Unit, and a member of the Cambridge Reproduction SRI.
The researchers say it is not entirely clear why gestational hypertension is associated with heart disease in later life. However, they suggest it may be that high blood pressure in pregnancy causes lasting damage that contributes to cardiovascular disease. Alternatively, women who develop gestational hypertension may have a pre-existing susceptibility to cardiovascular disease that is revealed due to the large demands that pregnancy places upon women’s bodies.
Reference
Charmaine Chu Wen Lo, Andre C. Q. Lo, Shu Hui Leow, Grace Fisher, Beth Corker, Olivia Batho, Bethan Morris, Monika Chowaniec, Catherine J. Vladutiu, Abigail Fraser and Clare Oliver‐Williams, ‘Future cardiovascular disease risk for women with gestational hypertension: a systematic review and meta‐analysis’, Journal of the American Heart Association 9(13): e013991 (2020). DOI: https://doi.org/10.1161/JAHA.119.013991.