For a study, researchers sought to assess the relationship between HDP and long-term Cardiovascular (CVD) and determine the amount of the connection that was mediated by recognized CVD risk factors. The Nurses’ Health Study II (n = 60,379) parous individuals without CVD were tracked for incident CVD from birth to 2017. Cox proportional hazards models produced HRs and 95 percent CIs for the link between HDP and CVD after controlling for possible confounders such as prepregnancy BMI, smoking, and parental CVD history. The difference approach was used to assess the amount of the association accounted for by chronic hypertension, hypercholesterolemia, type 2 diabetes, and changes in body mass index.
Those with HDP in their first pregnancy had a 63% greater risk of CVD (95% CI: 1.37-1.94) than women with normotensive pregnancies. This relationship was mediated by known CVD risk variables (proportion mediated = 64%). Preeclampsia was associated with a greater incidence of CVD (HR: 1.72; 95% CI: 1.42-2.10) than gestational hypertension (HR: 1.41; 95% CI: 1.03-1.93). Established CVD risk variables accounted for 57% of the higher CVD incidence in preeclampsia but 84% in gestational hypertension (both P<0.0001).
Established CVD risk factors occurring after pregnancy explained the majority (84%) of the elevated risk of CVD given by gestational hypertension and 57% of the risk among preeclamptic women. After-pregnancy screening for chronic hypertension, hypercholesterolemia, type 2 diabetes, and overweight/obesity may be especially beneficial in CVD prevention in women with a history of HDP.