Hypertension During Pregnancy Linked to Later Heart Disease - CME Teaching Brief® - MedPage Today

Although hypertension during pregnancy usually subsides after delivery, a postmenopausal second act may await, found researchers here.

The postmenopausal course of women with a history of hypertension during pregnancy may be marked by coronary calcification and an increased risk of coronary artery disease, said Michiel Bots, M.D., Ph.D., of the Julius Center for Health Sciences and Primary Care here, and colleagues.

They found women with mild elevations of blood pressure from preeclampsia had a 57% increased risk of coronary calcification several decades later compared with women who were normotensive during pregnancy, they reported in the February issue of Hypertension.

"To the best of our knowledge, the present study is the first to show that a history of high blood pressure during pregnancy is related to coronary calcification later in life," they said.

Many women who have had preeclampsia exhibit the phenotype of the metabolic syndrome and impaired endothelial function three to 12 months postpartum, the researchers said. In addition, preeclampsia is associated with an increased risk of cardiovascular events and death later in life.

The findings of this study are in line with these observations, they said, and expand the evidence to an increased risk of atherosclerosis, a significant predictor of subsequent cardiovascular disease and total mortality.

The study population included 491 healthy postmenopausal women selected from participants enrolled in the PROSPECT study from 1993 to 1997. PROSPECT was one of two Dutch cohorts participating in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Information on high blood pressure during pregnancy was obtained by questionnaire. Of the women, 151 (30.7%) reported having had high blood pressure in pregnancy.

The high prevalence of hypertension was most likely the result of a definition of "hypertension during pregnancy" that included not only brief and modest elevations during pregnancy but also women with preeclampsia, the researchers said. Unfortunately, they added, blood pressure levels for women with nonproteinuric hypertension or mild elevations were not available. [MORE]