Hypertension during pregnancy is associated with coronary artery calcium independent of renal function.
BACKGROUND
Hypertension during pregnancy (HDP) increases the risk of future coronary heart disease (CHD), but it is unknown whether this association is mediated by renal injury. Reduced renal function is both a complication of HDP and a risk factor for CHD.


METHODS
Logistic regression models were fit to examine the association between a history of HDP and the presence and extent of coronary artery calcification (CAC), a measure of subclinical coronary artery atherosclerosis, in 498 women from the Epidemiology of Coronary Artery Calcification Study (mean age 63.3 +/- 9.3 years).


RESULTS
Fifty-two (10.4%) women reported a history of HDP. After adjusting for age at time of study participation, HDP was associated with increased serum creatinine later in life (p = 0.014). HDP was positively associated with the presence of CAC after adjusting for age at time of study participation (OR = 2.7, 95% CI 1.4-5.4). This association was slightly attenuated with adjustment for body size and blood pressure (OR = 2.4, 95% CI 1.2-4.9) but was not further attenuated with adjustment for serum creatinine and urinary albumin/creatinine ratio (OR = 2.6, 95% CI 1.3-5.3). Results were similar for CAC extent.


CONCLUSIONS
HDP may increase a woman's risk of future CHD beyond traditional risk factors and renal function. Women with a history of HDP should be monitored for potential increased risk of CHD as they age.
Department of Biostatistics, Henry Ford Hospital, Detroit, Michigan, USA.
Andrea E
AE
Cassidy-Bushrow
Lawrence F
LF
Bielak
Andrew D
AD
Rule
Patrick F
PF
Sheedy
Stephen T
ST
Turner
Vesna D
VD
Garovic
Patricia A
PA
Peyser
D000328:Adult; D000367:Age Factors; D000368:Aged; D002114:Calcinosis / Q000175:diagnosis / Q000453:epidemiology*; D015984:Causality; D015897:Comorbidity; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D003331:Coronary Vessels / Q000473:pathology; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D012307:Risk Factors; D016387:Women's Health
D003404:Creatinine