Hypertension During Pregnancy Linked to Future Cardiac Events

An NIH-funded study explains factors related to increased risk for heart attack or stroke among women who had hypertension while pregnant.

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An NIH-funded study explains factors related to increased risk for heart attack or stroke among women who had hypertension, or high blood pressure, while pregnant. Women who experienced such complications during pregnancy had a 63 percent increased risk for developing cardiovascular disease later in life.

While hypertensive pregnancy complications previously have been linked to increased cardiovascular risks, the current study controlled for pre-pregnancy shared risk factors including obesity before pregnancy and family history of heart attack or stroke. Researchers also found that high blood pressure, high cholesterol, type 2 diabetes or being overweight or obese after pregnancy accounted for most of the increased risk between pregnancy complications and future cardiovascular events.

The findings, published in the Journal of the American College of Cardiology, could support health care providers in developing personalized heart disease prevention and monitoring strategies for women who had hypertension during pregnancy. The information could also help bridge the gap that often occurs after a woman ends obstetric care and resumes or starts care with another provider.

Using health data shared by more than 60,000 participants in the Nurses’ Health Study II, the research represents one of the most comprehensive reviews evaluating links between future cardiovascular events in women who have had preeclampsia or gestational hypertension—or increased blood pressure during pregnancy. Preeclampsia, a more severe complication marked by a sudden rise in blood pressure, can affect the organs and be dangerous for both mother and baby. Both conditions are often diagnosed after 20 weeks of pregnancy. 

“Women with a history of gestational hypertension or preeclampsia should be informed that they have an increased risk for cardiovascular disease,” said Dr. Jennifer J. Stuart, a study author and associate epidemiologist at Brigham and Women’s Hospital and Harvard Medical School. “Women and their providers have lacked clear direction on what to do in the intervening years between delivery of a hypertensive pregnancy and the onset of cardiovascular disease.”

The research was supported by grants from NHLBI, NCI and NICHD.