Cardiovascular sequelae of preeclampsia/eclampsia: A systematic review and meta-analyses

McDonald, Sarah D.; Malinowski, Ann Kinga; Zhou, Qi; Yusuf, Salim; Devereaux, P. J.

doi:10.1016/j.ahj.2008.06.042

Cited by 805 publications

(611 citation statements)

References 39 publications

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“…These women also have roughly double the risk of venous thromboembolism and 4 times the risk of DM compared with those with normotensive pregnancies 38, 45. In addition, although preeclampsia is associated with only a modest increase in overall mortality, it has been found to be associated with a 1.7‐ to 3.6‐fold increase in CVD mortality across various studies 38, 41, 42, 46, 47…”

Section: Hdp and Long‐term Risk Of Maternal Cvdmentioning

confidence: 99%

“…37, 38, 39 Of the HDP categories, the association between preeclampsia and future CVD risk has been studied most extensively. Several large meta‐analyses, each studying >2 million women, found the risk of CVD to be roughly 2 times higher among women with a history of preeclampsia than women with normotensive pregnancies 40, 41, 42. More specifically, one meta‐analysis demonstrated a 4.2‐fold increased risk of heart failure, a 2.5‐fold increased risk of coronary artery disease, and a 1.8‐fold increased risk of stroke in women with preeclamptic pregnancies over a follow‐up period of up to 39 years 42.…”

Section: Hdp and Long‐term Risk Of Maternal Cvdmentioning

confidence: 99%

“…Notably, a dose‐response relationship has been observed between the severity of preeclampsia and the long‐term risk of CVD 41, 43, 45. In a meta‐analysis of >2.3 million women, mild, moderate, and severe preeclampsia was associated with relative risk of 2.00, 2.99, and 5.36, respectively, of developing future CVD 41.…”

Section: Hdp and Long‐term Risk Of Maternal Cvdmentioning

confidence: 99%

“…In a meta‐analysis of >2.3 million women, mild, moderate, and severe preeclampsia was associated with relative risk of 2.00, 2.99, and 5.36, respectively, of developing future CVD 41. In another study analyzing specific cardiovascular outcomes, including hypertension, coronary artery disease, heart failure, stroke, venous thromboembolism, and DM, the risks of all above end points were increased in women with a history of severe preeclampsia compared with those with mild preeclampsia 38.…”

Section: Hdp and Long‐term Risk Of Maternal Cvdmentioning

confidence: 99%

See 3 more Smart Citations

Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk

Ying

Catov

Ouyang

2018

JAHA

181

119

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Section: Hdp and Long‐term Risk Of Maternal Cvdmentioning

confidence: 99%

Section: Hdp and Long‐term Risk Of Maternal Cvdmentioning

confidence: 99%

Section: Hdp and Long‐term Risk Of Maternal Cvdmentioning

confidence: 99%

Section: Hdp and Long‐term Risk Of Maternal Cvdmentioning

confidence: 99%

See 2 more Smart Citations

Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk

Ying

Catov

Ouyang

2018

JAHA

181

119

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“…Pregnancy complications, such as hypertensive disorders of pregnancy, are well established as independent risk factors for cardiovascular diseases in later life in both the mother1, 2 and the offspring 3, 4. Studies of women from 1 to 40 years after childbirth consistently show increased rates of hypertension, ischemic heart disease, cerebrovascular disease, and cardiovascular mortality following a hypertensive pregnancy 1, 2.…”

Section: Introductionmentioning

confidence: 99%

Do Young Women Need Treatment for Hypertension After Pregnancy Complications?

Aye

Elmahi

Boardman

et al. 2018

JAHA

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Association Between Hypertensive Disorders of Pregnancy and Later Risk of Cardiomyopathy

Behrens

Basit

Lykke

et al. 2016

JAMA

115

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IMPORTANCE Women with hypertensive disorders of pregnancy, preeclampsia in particular, have an increased risk of cardiomyopathy during the peripartum period. Whether hypertensive disorders of pregnancy are also associated with cardiomyopathy later in life is unknown.OBJECTIVE To determine whether hypertensive disorders of pregnancy are associated with cardiomyopathy beyond the peripartum period. DESIGN, SETTING, AND PARTICIPANTSNationwide register-based cohort study using Cox regression to compare rates of cardiomyopathy in women with and without a history of hypertensive disorders of pregnancy in a cohort of 1 075 763 women with at least 1 pregnancy ending in live birth or stillbirth in Denmark, 1978, with follow-up through December 31, 2012.EXPOSURES A hypertensive disorder of pregnancy (severe or moderate preeclampsia or gestational hypertension) registered in the National Patient Register.MAIN OUTCOMES AND MEASURES Cardiomyopathy more than 5 months after delivery (outside the peripartum period) up to 34 years 7 months.RESULT The women in the primary cohort had 2 067 633 eligible pregnancies during the study period, 76 108 of which were complicated by a hypertensive disorder of pregnancy. During follow-up, 1577 women (mean age, 48.5 years at cardiomyopathy diagnosis; 2.6% with multiple pregnancies) developed cardiomyopathy. Compared with women with normotensive pregnancies (18 211 603 person-years of follow-up; n = 1408 cardiomyopathy events, 7.7/100 000 person-years [95% CI, 7.3-8.2]), women with a history of hypertensive disorders of pregnancy had significantly increased rates of cardiomyopathy (in 173 062 person-years of follow-up among women with severe preeclampsia, n = 27 cardiomyopathy events; 15.6/100 000 person-years [95% CI, 10.7-22.7]; adjusted hazard ratio [HR], 2.20 [95% CI,; in 697 447 person-years of follow-up among women with moderate preeclampsia, n = 102 cardiomyopathy events; 14.6/100 000 person-years [95% CI, 12.0-17.8]; adjusted HR, 1.89 [95% CI, 1.55-2.23]; in 213 197 person-years of follow-up among women with gestational hypertension, n = 40 cardiomyopathy events; 17.3/100 000 person-years [95% CI, 12.7-23.6]; adjusted HR, 2.06 [95% CI, 1.50-2.82]). These increases persisted more than 5 years after the latest pregnancy. Mediation analyses suggested that only about 50% of the association was an indirect association through postpregnancy chronic hypertension. In this cohort, 11% of all cardiomyopathy events occurred in women with a history of hypertensive disorders of pregnancy. CONCLUSIONS AND RELEVANCEWomen with a history of hypertensive disorders of pregnancy, compared with women without such a history, had a small but statistically significant increased risk of cardiomyopathy more than 5 months after delivery. Further research is necessary to understand whether there is a causal mechanism behind this association.

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Cardiovascular sequelae of preeclampsia/eclampsia: A systematic review and meta-analyses

Cited by 805 publications

References 39 publications

Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk

Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk

Do Young Women Need Treatment for Hypertension After Pregnancy Complications?

Association Between Hypertensive Disorders of Pregnancy and Later Risk of Cardiomyopathy

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