title: Hypertension in pregnancy is associated with elevated homocysteine levels later in life.
abstract: OBJECTIVE
  Hyperhomocysteinemia is associated with an elevated cardiovascular disease risk. We examined whether women with a history of hypertension in pregnancy are more likely to have a high level of serum homocysteine decades after pregnancy.
  
  
  METHODS
  Serum homocysteine was measured at a mean age of 60 years in nulliparous women (n = 216), and women with a history of normotensive (n = 1825) or hypertensive (n = 401) pregnancies who participated in the Genetic Epidemiology Network of Arteriopathy (GENOA) study. Relationships between homocysteine and pregnancy history were examined by linear and logistic regression, controlling for multiple covariates including personal and family history of hypertension, diabetes, obesity, tobacco use, and demographics.
  
  
  RESULTS
  A history of hypertension in pregnancy, when compared with normotensive pregnancy, was associated with a 4.5% higher serum homocysteine level (P = .015) and 1.60-fold increased odds of having an elevated homocysteine (95% confidence interval, 1.15-2.21; P = .005) after adjusting for potentially confounding covariates. In contrast, a history of normotensive pregnancy, as compared with nulliparity, was associated with a 6.1% lower serum homocysteine level (P = .005) and a 0.49-fold reduced odds of elevated homocysteine levels (95% confidence interval, 0.32-0.74; P < .001).
  
  
  CONCLUSIONS
  Homocysteine levels decades after pregnancy are higher in women with a history of pregnancy hypertension, even after controlling for potential confounders. Thus, pregnancy history may prompt homocysteine assessment and risk modification in an attempt at primary prevention of cardiovascular disease.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN.
authors.forename: Wendy M
authors.initials: WM
authors.lastname: White
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Turner
authors.forename: Kent R
authors.initials: KR
authors.lastname: Bailey
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Mosley
authors.forename: Sharon L R
authors.initials: SL
authors.lastname: Kardia
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Wiste
authors.forename: Iftikhar J
authors.initials: IJ
authors.lastname: Kullo
authors.forename: Vesna D
authors.initials: VD
authors.lastname: Garovic
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000453:epidemiology*; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000453:epidemiology*; D016014:Linear Models; D016015:Logistic Models; D008875:Middle Aged; D011247:Pregnancy; D013997:Time Factors
chemical_list: D015415:Biomarkers; D006710:Homocysteine
keywords: biomarker; cardiovascular disease; homocysteine; hypertension in pregnancy; preeclampsia