Hypertension in pregnancy as a risk factor for cardiovascular disease later in life

Vesna D. Garovic, Kent R. Bailey, Eric Boerwinkle, Steven Hunt, Alan B. Weder, David Curb, Thomas H. Mosley, Heather J. Wiste, Stephen T. Turner

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Objective: The association between hypertension in pregnancy and future cardiovascular disease (CVD) increasingly is recognized. We aimed to assess the role of hypertension in pregnancy as an independent risk factor for hypertension, coronary heart disease (CHD), and stroke later in life. Methods: Women who participated in the Phase 2 (2000-2004) Family Blood Pressure Program study (nU4782) were categorized into women with no history of pregnancy lasting more than 6 months (nU718), women with no history of hypertension in pregnancy (nU3421), and women with a history of hypertension in at least one pregnancy (nU643). We used Kaplan-Meier and Cox proportional hazard models to estimate and contrast the risks of subsequent diagnoses of hypertension, CHD, and stroke among the groups. Results: Women with a history of hypertension in pregnancy, compared with those without such a history, were at increased risks for the subsequent diagnoses of hypertension (50% hypertensive at the age 53 vs. 60, P<0.001), CHD (14% estimated event rate vs. 11%, PU0.009), and stroke (12% estimated event rate vs. 5%, P<0.001). The increased risk for subsequent hypertension remained significant after controlling for race, family history of CVD, smoking, dyslipidemia, and diabetes mellitus, with an adjusted hazard ratio of 1.88 [95% confidence interval (CI) 1.49-2.39, P<0.001]. After controlling for traditional risk factors, including subsequent hypertension, the increased risk for stroke remained statistically significant (hazard ratio 2.10, 95% CI 1.19-3.71, PU0.01), but not for CHD. Conclusion: Hypertension in pregnancy may be an independent risk factor for subsequent diagnoses of hypertension and stroke.

Original languageEnglish
Pages (from-to)826-833
Number of pages8
JournalJournal of Hypertension
Volume28
Issue number4
DOIs
Publication statusPublished - Apr 2010
Externally publishedYes

Fingerprint

Cardiovascular Diseases
Hypertension
Pregnancy
Stroke
Coronary Disease
Confidence Intervals
Reproductive History
Dyslipidemias
Proportional Hazards Models
Diabetes Mellitus
Smoking
History
Blood Pressure

Keywords

  • Cardiovascular disease
  • Hypertension
  • Pregnancy
  • Rsk factors stroke

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Garovic, V. D., Bailey, K. R., Boerwinkle, E., Hunt, S., Weder, A. B., Curb, D., ... Turner, S. T. (2010). Hypertension in pregnancy as a risk factor for cardiovascular disease later in life. Journal of Hypertension, 28(4), 826-833. https://doi.org/10.1097/HJH.0b013e328335c29a

Hypertension in pregnancy as a risk factor for cardiovascular disease later in life. / Garovic, Vesna D.; Bailey, Kent R.; Boerwinkle, Eric; Hunt, Steven; Weder, Alan B.; Curb, David; Mosley, Thomas H.; Wiste, Heather J.; Turner, Stephen T.

In: Journal of Hypertension, Vol. 28, No. 4, 04.2010, p. 826-833.

Research output: Contribution to journalArticle

Garovic, VD, Bailey, KR, Boerwinkle, E, Hunt, S, Weder, AB, Curb, D, Mosley, TH, Wiste, HJ & Turner, ST 2010, 'Hypertension in pregnancy as a risk factor for cardiovascular disease later in life', Journal of Hypertension, vol. 28, no. 4, pp. 826-833. https://doi.org/10.1097/HJH.0b013e328335c29a
Garovic, Vesna D. ; Bailey, Kent R. ; Boerwinkle, Eric ; Hunt, Steven ; Weder, Alan B. ; Curb, David ; Mosley, Thomas H. ; Wiste, Heather J. ; Turner, Stephen T. / Hypertension in pregnancy as a risk factor for cardiovascular disease later in life. In: Journal of Hypertension. 2010 ; Vol. 28, No. 4. pp. 826-833.
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AU - Mosley, Thomas H.

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AB - Objective: The association between hypertension in pregnancy and future cardiovascular disease (CVD) increasingly is recognized. We aimed to assess the role of hypertension in pregnancy as an independent risk factor for hypertension, coronary heart disease (CHD), and stroke later in life. Methods: Women who participated in the Phase 2 (2000-2004) Family Blood Pressure Program study (nU4782) were categorized into women with no history of pregnancy lasting more than 6 months (nU718), women with no history of hypertension in pregnancy (nU3421), and women with a history of hypertension in at least one pregnancy (nU643). We used Kaplan-Meier and Cox proportional hazard models to estimate and contrast the risks of subsequent diagnoses of hypertension, CHD, and stroke among the groups. Results: Women with a history of hypertension in pregnancy, compared with those without such a history, were at increased risks for the subsequent diagnoses of hypertension (50% hypertensive at the age 53 vs. 60, P<0.001), CHD (14% estimated event rate vs. 11%, PU0.009), and stroke (12% estimated event rate vs. 5%, P<0.001). The increased risk for subsequent hypertension remained significant after controlling for race, family history of CVD, smoking, dyslipidemia, and diabetes mellitus, with an adjusted hazard ratio of 1.88 [95% confidence interval (CI) 1.49-2.39, P<0.001]. After controlling for traditional risk factors, including subsequent hypertension, the increased risk for stroke remained statistically significant (hazard ratio 2.10, 95% CI 1.19-3.71, PU0.01), but not for CHD. Conclusion: Hypertension in pregnancy may be an independent risk factor for subsequent diagnoses of hypertension and stroke.

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