pregnancy

Among Women With Preeclampsia, CV Mortality Risk Quadruples in the Long Term

Women with preeclampsia during their first pregnancy have a significantly higher risk of long-term adverse cardiovascular (CV) outcomes—including myocardial infarction (MI) and CV mortality—than women without preeclampsia, new findings show.1

According to the study authors, the results highlight the need for clinicians to monitor this patient population’s CV health postpartum. 

To evaluate the risks of CV outcomes over a 15-year period (1999-2013), the researchers identified women aged 18 years or older who had been pregnant for the first time from the New Jersey Electronic Birth Certificate database and the Myocardial Infarction Data Acquisition System. Among the identified women, 6360 had had preeclampsia and 325,347 had not.

“Women who were diagnosed with preeclampsia tended also to have a history of chronic [hypertension], gestational diabetes and kidney disease, and other medical conditions,” study lead author Mary Downes Gastrich, PhD, said in a press release.2

Compared with the controls, women with preeclampsia were more likely to experience MI, stroke, CV mortality, or all-cause mortality.

After adjusting for demographics and comorbidities, the outcomes of MI, CV mortality, and all-cause mortality in women with preeclampsia vs those without preeclampsia had hazard ratios significantly higher than 1. Women with preeclampsia had 3.94-times higher hazard for MI, 4.66-times higher hazard for CV mortality, and 2.32-times higher hazard for all-cause mortality than their matched controls.

According to Dr Gastrich, to prevent adverse CV outcomes, women with preeclampsia should receive treatment within 5 years postpartum.2

“Medication such as low-dose aspirin also may be effective, according to one study, in bringing down blood pressure as early as the second trimester​​,” Dr Gastrich said.2

—Colleen Murphy

References:

  1. Gastrich MD, Zinonos S, Bachmann G, et al; Myocardial Infarction Data Acquisition System (MIDAS 34) Study Group. Preeclamptic women are at significantly higher risk of future cardiovascular outcomes over a 15-year period. J Womens Health (Larchmt). 2020;29(1):74-83. https://doi.org/10.1089/jwh.2019.7671.
  2. Pregnant women with very high blood pressure face greater heart disease risk [press release]. New Brunswick, NJ: Rutgers University; February 6, 2020. https://news.rutgers.edu/research-news/pregnant-women-very-high-blood-pressure-face-greater-heart-disease-risk/20200204#.XjwW2xNKjOR. Accessed February 6, 2020.