High blood pres­sure in preg­nancy tied to heart dis­ease risk

The Borneo Post - Nature and health - - Front Page - By Lisa Ra­pa­port

WOMEN who de­velop high blood pres­sure dur­ing preg­nancy may be more likely to ex­pe­ri­ence it again later or be diagnosed with other risk fac­tors for heart dis­ease like high choles­terol or di­a­betes, a US study sug­gests. Pre-eclamp­sia and ges­ta­tional hy­per­ten­sion are two forms of high blood pres­sure that com­monly de­velop dur­ing preg­nancy. While pre­vi­ous re­search has linked these preg­nancy con­di­tions to an in­creased risk of heart at­tack and stroke later in life, the cur­rent find­ings of­fer fresh in­sight into which women may be at risk.

For the study, re­searchers ex­am­ined data on al­most 59,000 women who gave birth for the first time be­tween 1964 and 2008, at an av­er­age age of 27. Over­all, 2.9 per cent of them de­vel­oped ges­ta­tional hy­per­ten­sion and 6.3 per cent de­vel­oped pre-eclamp­sia, the more se­vere form of high blood pres­sure dur­ing preg­nancy. Com­pared with women who had nor­mal blood pres­sure through­out their first preg­nancy, women who de­vel­oped ges­ta­tional hy­per­ten­sion were al­most three times more likely to have high blood pres­sure again in the fu­ture, while women with pre-eclamp­sia had more than dou­ble the risk.

Pre-eclamp­sia, mean­while, was as­so­ci­ated with 75 per cent greater chance that women would de­velop di­a­betes and a 31 per cent in­creased risk of high choles­terol. “It is im­por­tant that these women tell their doc­tor about their pre-eclamp­sia or ges­ta­tional hy­per­ten­sion his­tory (be­cause) it in­creases their risk for car­dio­vas­cu­lar dis­ease risk fac­tors and events,” said lead study au­thor Jen­nifer Stu­art of the Har­vard T.H. Chan School of Pub­lic Health and Brigham and Women’s Hospi­tal in Bos­ton.

“While doc­tors typ­i­cally screen for these car­dio­vas­cu­lar dis­ease risk fac­tors in older adults, we see that women with high blood pres­sure dur­ing preg­nancy de­velop these risk fac­tors ear­lier in life than women with nor­mal blood pres­sure in preg­nancy,” Stu­art added by email. “There­fore, it is es­pe­cially im­por­tant for these women to reg­u­larly see their doc­tor af­ter preg­nancy to mon­i­tor their blood pres­sure, glu­cose, and choles­terol.”

For women with ges­ta­tional hy­per­ten­sion or pre-eclamp­sia, the risk of de­vel­op­ing high blood pres­sure, di­a­betes or el­e­vated choles­terol was high­est in the first years af­ter they gave birth, re­searchers re­port in the An­nals of In­ter­nal Medicine. Other risk fac­tors for heart at­tack and stroke like obe­sity, smok­ing and a fam­ily his­tory of heart dis­ease didn’t ap­pear to in­flu­ence whether women with pre-eclamp­sia or ges­ta­tional hy­per­ten­sion de­vel­oped risk fac­tors for heart dis­ease af­ter preg­nancy, re­searchers found.

The study wasn’t a con­trolled ex­per­i­ment de­signed to prove whether or how el­e­vated blood pres­sure dur­ing preg­nancy might di­rectly cause heart prob­lems in the fu­ture. And the study looked at risk fac­tors for heart dis­ease, not ac­tual car­dio­vas­cu­lar events like heart at­tacks or strokes.

Re­searchers also re­lied on sur­vey par­tic­i­pants to ac­cu­rately re­call and re­port any di­ag­no­sis of high blood pres­sure dur­ing preg­nancy, and their rec­ol­lec­tions might not al­ways be ac­cu­rate. An­other lim­i­ta­tion is that all of the par­tic­i­pants were nurses, and it’s pos­si­ble re­sults might look dif­fer­ent for women with dif­fer­ent ca­reer paths.

Even so, the re­sults of­fer fresh ev­i­dence that women who de­velop high blood pres­sure in preg­nancy may have a greater risk for heart dis­ease at an ear­lier age than their peers who don’t ex­pe­ri­ence pre-eclamp­sia or ges­ta­tional hy­per­ten­sion, Dr Abi­gail Fraser, au­thor of an ac­com­pa­ny­ing edi­to­rial and a re­searcher at the Univer­sity of Bris­tol in the UK. “This has po­ten­tial im­pli­ca­tions for care,” Fraser said by email. “Women with a his­tory of hy­per­ten­sion dur­ing preg­nancy should po­ten­tially have their blood pres­sure, glu­cose and choles­terol lev­els checked at reg­u­lar in­ter­vals and at an ear­lier age.” – Reuters

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