Hypertensive diseases of pregnancy and risk of hypertension and stroke in later life: results from cohort study

Wilson, Brenda J.

doi:10.1136/bmj.326.7394.845

Cited by 626 publications

(438 citation statements)

References 23 publications

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“…Other studies report more inconsistent, conflicting, or negative results, with no association between GH alone and CVD for nonblacks after stratifying by race,5 with a positive association between GH and CVD but not for thromboembolic events (deep venous thrombosis or pulmonary embolism),27 and lack of positive association between GH and CVD 28. Compared with our study, these studies had limitations in terms of small population size and relatively short follow‐up for cardiovascular events 25, 26, 27, 28…”

Section: Discussioncontrasting

confidence: 71%

“…A possible relationship between GH and risk of maternal CVD has been studied to a much smaller extent. While several studies have reported a significant association between GH and subsequent CVD,5, 19, 20, 23, 24, 25, 26, 27, 28, 29, 30 only 4 of these had a comparable cohort size and a similar follow‐up time compared with our study 19, 20, 23, 29. None of these studies looked at the combined effects of GH, SGA infant, preterm delivery, and parity as predictors of subsequent CVD.…”

Section: Introductionmentioning

confidence: 68%

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Association Between Gestational Hypertension and Risk of Cardiovascular Disease Among 617 589 Norwegian Women

Riise

Sulo

Tell

et al. 2018

JAHA

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BackgroundPreeclampsia and gestational hypertension (GH) are the most common hypertensive pregnancy disorders. Preeclampsia has been linked to increased risk of cardiovascular disease (CVD), but a similar association for GH has not been established. We aimed to determine the association between GH and subsequent CVD, and explore the additional role of small‐for‐gestational‐age infants, preterm delivery, and parity.Methods and ResultsData from the Medical Birth Registry of Norway were linked to the Cardiovascular Disease in Norway project and the Norwegian Cause of Death Registry. Hazard ratios and 95% confidence intervals were computed using Cox proportional hazard regression, comparing women with and without GH during their first and/or second pregnancy. We included all women with a first delivery from 1980 through 2009 (n=617 589) and followed them for a median of 14.3 (quartile 1–quartile 3: 6.9–21.5) years. Women with GH in the first pregnancy had 1.8‐fold (95% confidence interval, 1.7–2.0) higher risk of subsequent CVD compared with women without any hypertensive pregnancy disorder. When GH occurred in combination with small‐for‐gestational‐age infants and/or preterm delivery, the hazard ratio was 2.6 (95% confidence interval, 2.3–3.0). When women with GH were compared with women with preeclampsia, the risk of CVD was comparable when the pregnancy complications occurred in either the first or second pregnancy but was significantly higher for preeclampsia without complications when the disorder occurred in both pregnancies.Conclusions GH was associated with increased risk of subsequent CVD, and the highest risk was observed when GH was combined with small‐for‐gestational‐age infants and/or preterm delivery.

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Section: Discussioncontrasting

confidence: 71%

Section: Introductionmentioning

confidence: 68%

Association Between Gestational Hypertension and Risk of Cardiovascular Disease Among 617 589 Norwegian Women

Riise

Sulo

Tell

et al. 2018

JAHA

View full text Add to dashboard Cite

show abstract

“…Furthermore, it has been clearly shown that preeclampsia places women at long-term risk for CV diseases and that careful follow-up and aggressive preventive strategies are recommended. [32][33][34] For example, a meta-analysis which includes 43 million women and almost 200 00 women with preeclampsia showed that women who had preeclampsia are 2.7 times more likely to develop hypertension, and almost twice more likely to have ischemic heart disease, stroke or venous thromboembolism. 34 …”

Section: Hormone Replacement Therapy and Bpmentioning

confidence: 99%

Hypertension in women

Pimenta

2011

Hypertens Res

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Hypertension is an important modifiable risk factor for cardiovascular (CV) morbidity and mortality, and a highly prevalent condition in both men and women. However, the prevalence of hypertension is predicted to increase more among women than men. Combined oral contraceptives (COCs) can induce hypertension in a small group of women and, increase CV risk especially among those with hypertension. Both COC-related increased CV risk and blood pressure (BP) returns to pretreatment levels by 3 months of its discontinuation. The effects of menopause and hormone replacement therapy (HRT) on BP are controversial, and COCs and HRT containing the new generation progestin drospirenone are preferred in women with established hypertension. Despite the high incidence of cancer in women, CV disease remains the major cause of death in women and comparable benefit of antihypertensive treatment have been demonstrated in both women and men. Hypertension Research (2012) 35, 148-152; doi:10.1038/hr.2011; published online 1 December 2011Keywords: blood pressure; treatment; women INTRODUCTIONHypertension is an important modifiable risk factor for cardiovascular (CV) morbidity and mortality, and a highly prevalent condition in both men and women. Blood pressure (BP) is generally higher in men than in women regardless of age. Mean systolic BP in the overall population increases progressively throughout adult life in both men and women. During early adulthood mean systolic BP is higher in men than women, but the subsequent rate of rise in BP is steeper for women than men. Prevalence and severity of hypertension increase markedly with advancing age in women, such that a higher percentage of women than men have high BP after 65 years. 1-5 Furthermore, BP control is more difficult to achieve in older women. Data from the Framingham Heart Study showed gender differences in BP control rates and in the pattern of antihypertensive medications prescribed. 3 An age-related decrease in BP control rates were more pronounced in women than in men. Among the oldest participants with hypertension, only 23% of women (vs. 38% of men) were controlled to BP o140/90 mm Hg. Treatment with thiazide diuretics was also more frequent among women than men (38 vs. 23%). It is unknown whether the age-related decline in BP control among women is related to true treatment resistance because of biological factors or to inappropriate drug choices in the clinical setting.This article discusses practical aspects related to hypertension in women and some topics are discussed in detail in separate articles in this special review edition.

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“…1,[3][4][5] Although little is known about the pathophysiology of gestational hypertension, studies have shown that it is associated with features of the metabolic syndrome 6 and with later development of essential hypertension and cardiovascular disease. 7,8 This suggests that these conditions may have similar pathological mechanisms.…”

Section: Introductionmentioning

confidence: 97%

Maternal educational level and risk of gestational hypertension: the Generation R Study

et al. 2008

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We examined whether maternal educational level as an indicator of socioeconomic status is associated with gestational hypertension. We also examined the extent to which the effect of education is mediated by maternal substance use (that is smoking, alcohol consumption and illegal drug use), pre-existing diabetes, anthropometrics (that is height and body mass index (BMI)) and blood pressure at enrolment. This was studied in 3262 Dutch pregnant women participating in the Generation R Study, a population-based cohort study. Level of maternal education was established by questionnaire at enrolment, and categorized into high, mid-high, mid-low and low. Diagnosis of gestational hypertension was retrieved from medical records using standard criteria. Odds ratios (OR) of gestational hypertension for educational levels were calculated, adjusted for potential confounders and additionally adjusted for potential mediators. Adjusted for age and gravidity, women with mid-low (OR: 1.52; 95% CI: 1.02, 2.27) and low education (OR: 1.30; 95% CI: 0.80, 2.12) had a higher risk of gestational hypertension than women with high education. Additional adjustment for substance use, pre-existing diabetes, anthropometrics and blood pressure at enrolment attenuated these ORs to 1.09 (95% CI: 0.70, 1.69) and 0.89 (95% CI: 0.50, 1.58), respectively. These attenuations were largely due to the effects of BMI and blood pressure at enrolment. Women with relatively low educational levels have a higher risk of gestational hypertension, which is largely due to higher BMI and blood pressure levels from early pregnancy. The higher risk of gestational hypertension in these women is probably caused by pre-existing hypertensive tendencies that manifested themselves during pregnancy.

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Hypertensive diseases of pregnancy and risk of hypertension and stroke in later life: results from cohort study

Cited by 626 publications

References 23 publications

Association Between Gestational Hypertension and Risk of Cardiovascular Disease Among 617 589 Norwegian Women

Association Between Gestational Hypertension and Risk of Cardiovascular Disease Among 617 589 Norwegian Women

Hypertension in women

Maternal educational level and risk of gestational hypertension: the Generation R Study

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