Cardiovascular and thromboembolic events following hypertensive pregnancy.
BACKGROUND
Hypertension is a common complication of pregnancy. Previous evidence has linked pregnancy-related hypertension to maternal cardiovascular disease. We conducted a population-based cohort study to estimate the risks for cardiovascular and thromboembolic events in women with pregnancy-related hypertension.


METHODS
We analyzed data from all singleton births recorded in Washington State from 1987 to 1998. Mothers were classified as having gestational hypertension, preeclampsia, or chronic hypertension based on hospital discharge and birth record information. Birth records were linked to subsequent hospitalizations within Washington State. Proportional hazards models were used to estimate the relationship between each form of pregnancy-related hypertension and subsequent risk for cardiovascular and thromboembolic events.


RESULTS
We identified 31,239 eligible hypertensive pregnancies from 807,010 births. During follow-up, there were 118 hospitalizations for a first acute cardiovascular event and 172 hospitalizations for a first thromboembolic event. Gestational hypertension, mild preeclampsia, and severe preeclampsia were associated with 2.8-fold (95% confidence interval [CI], 1.6 to 4.8), 2.2-fold (95% CI, 1.3 to 3.6), and 3.3-fold (95% CI, 1.7 to 6.5) greater risks for cardiovascular events, respectively. Severe preeclampsia was associated with a 2.3-fold (95% CI, 1.3 to 4.2) greater risk for thromboembolic events.


CONCLUSIONS
Preeclampsia and gestational hypertension are associated with increased risk for cardiovascular events. Pregnancy-induced hypertension appears to be an important risk factor for the development of future cardiovascular disease in young women.
Kestenbaum
Bryan
B
Department of Medicine, Division of Nephrology, University of Washington, Seattle, WA, USA. brk@u.washington.edu
Seliger
Stephen L
SL
Easterling
Thomas R
TR
Gillen
Daniel L
DL
Critchlow
Cathy W
CW
Stehman-Breen
Catherine O
CO
Schwartz
Stephen M
SM
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000150:complications*; D015999:Multivariate Analysis; D011225:Pre-Eclampsia / Q000150:complications*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D016016:Proportional Hazards Models; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology*