Women who experience hypertensive disorders of pregnancy have significantly increased risk of developing serious heart disease or even dying within five years of giving birth.
Hypertensive disorders of pregnancy affect about 5-10% of pregnancies worldwide. They include four main types: chronic hypertension, gestational hypertension, preeclampsia, and eclampsia.
The study was presented at the American Heart Association conference in New Orleans and included 218,141 live births, from 157,606 mothers that occurred from 2017-2024 in 22 Intermountain Health hospitals across the Utah, Colorado, Idaho, Montana, and Nevada regions of the U.S.
In the study, 31,077 cases of hypertensive disorders of pregnancy were reported. Most were diagnosed on first pregnancy. The average age of the study population was 29 years, and the majority of the women were White (87%).
During an average follow-up period of 4.8 years, women with hypertension during pregnancy were more likely to experience cardiovascular disease or events linked to cardiovascular disease than women who did not have hypertension.
Of the women with hypertensive disorders, most had gestational hypertension (12,076 women) followed by some form of preeclampsia (more than 11,046 women). Risks for cardiovascular outcomes varied depending on the type of hypertension experienced by the participants, with more severe cases translating to more severe cardiovascular outcomes.
Those with some form of hypertension during pregnancy had higher risk of heart failure (3–13 fold increase), stroke (2–17 fold increase), heart attack (3–7 fold increase), coronary artery disease (2–7 fold increase), and death (1-4 fold increase) during the follow up period than women with no hypertension.
The researchers note that women who had some form of hypertension during pregnancy did have more comorbidities than the women with no hypertension. For example, they were more likely to be obese, to smoke, to have diabetes, and to have hyperlipidemia.
However, despite this, they say the results need to be communicated further to inform women and their healthcare providers about the risks linked to these conditions during pregnancy.
“We need to do a better job identifying women with these risk factors and ensuring they receive appropriate care before, during, and after pregnancy,” said Kismet Rasmusson, DNP, principal investigator and presenter of the study, an advanced practice clinician with Intermountain Health’s Advanced Heart Failure Program. “This is especially critical for those with severe forms of hypertensive disorders of pregnancy.”
