Hypertension in pregnancy as an early sex-specific risk factor for cardiovascular diseases: evidence and awareness

Abstract

Despite being a physiological condition, human pregnancy is known to cause numerous complications that can endanger the life of the mother and the fetus alike. While the majority of complications are mostly limited within the peripartum period, more and more information is available about persistently higher short- and long-term cardiovascular risk after a pregnancy complicated by a hypertensive disorder. There is evidence that women after gestational hypertension or preeclampsia are more likely to develop arterial hypertension, coronary atherosclerosis, myocardial infarction, stroke, peripheral artery disease, and even diabetes mellitus and venous thromboembolism years after the target pregnancy. This has urged some authors to view hypertensive disorders of pregnancy as a “stress test” for the maternal organism that unmasks latent endothelial dysfunction. An explanation is sought in the presence of common risk factors and underlying pathological pathways with cardiovascular diseases, although a certain etiological mechanism for the development of hypertensive disorders in pregnancy has not been established yet. More attention is needed towards the follow-up of women after a hypertensive pregnancy as it could be an opportunity for early prevention of cardiovascular diseases.

Understanding patient perspectives of specialized, longitudinal postpartum cardiovascular risk reduction clinics

“…over the lifespan that also are associated with increased risks of CVD. 2 , 3 , 4 , 5 The hypertensive disorders of pregnancy (HDP) are a common female-specific cardiovascular risk factor (∼5%-10% of all pregnancies in Canada) that is associated with a 2-4 times higher lifelong risk of CVD. 4 , 6 , 7 , 8 An Important finding is that female patients who experience HDP have high rates of premature cardiovascular events, before the age of 50 years.…”

“… 2 , 3 , 4 , 5 The hypertensive disorders of pregnancy (HDP) are a common female-specific cardiovascular risk factor (∼5%-10% of all pregnancies in Canada) that is associated with a 2-4 times higher lifelong risk of CVD. 4 , 6 , 7 , 8 An Important finding is that female patients who experience HDP have high rates of premature cardiovascular events, before the age of 50 years. 9 , 10 , 11 , 12 Although research actively examines mechanisms linking the HDP with future CVD, to identify targeted interventions to modify the risks of CVD after HDP, strong evidence indicates that female patients with HDP develop traditional atherosclerotic risk factors early in life (commonly from preconception to 5 years after delivery) that may accelerate the progression to CVD.…”