Stuart J, et al. - In this observational cohort study, researchers determined connections between hypertensive disorders of pregnancy (HDP) and maternal cardiovascular disease (CVD) risk factors and map the course of the development of risk factors following pregnancy. It was observed that women with HDP during their first pregnancy had higher rates of chronic hypertension, type 2 diabetes mellitus (T2DM), and hypercholesterolemia that endured for several decades. In order to reduce lifetime risk for CVD, these women might benefit from lifestyle intervention and early screening.

Methods

• This observational cohort study was performed at US.
• Participants in the study were 58,671 parous NHS II (Nurses' Health Study II) members who did not have CVD or risk factors of interest at baseline.
• For this investigation, women were followed for self-reported physician diagnosis of chronic hypertension and hypercholesterolemia and confirmed type 2 diabetes mellitus (T2DM) from their first birth through 2013.
• Mean follow-up ranged from 25 to 32 years across these end points.
• Multivariable Cox proportional hazards models assessed hazard ratios (HRs) and 95% CIs, with adjustment for prepregnancy confounders.

Results

• The study results showed that women with gestational hypertension (2.9%) or preeclampsia (6.3%) in their first pregnancy had increased rates of chronic hypertension (HRs, 2.8 [95% CI, 2.6 to 3.0] and 2.2 [CI, 2.1 to 2.3], respectively), T2DM (HRs, 1.7 [CI, 1.4 to 1.9] and 1.8 [CI, 1.6 to 1.9], respectively), and hypercholesterolemia (HRs, 1.4 [CI, 1.3 to 1.5] and 1.3 [CI, 1.3 to 1.4], respectively) vs women who were normotensive during pregnancy.
• Findings revealed that the relative risk for chronic hypertension was strongest within 5 years after their first birth, although these women were more likely to develop CVD risk factors throughout follow-up.
• Data reported that recurrence of HDP further elevated risks for all end points.