Women who have hypertensive pregnancies may be at higher risk for hypertension as they age


CHICAGO —Hypertension that develops during pregnancy places women at higher risk for the condition when they get older, researchers reported at the American Heart Association 2006 Scientific Sessions.

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They studied 4,782 women who participated in the Family Blood Pressure Program who were at increased risk for hypertension be-cause they had one or more siblings who developed hypertension before age 60, said Vesna D. Garovic, MD, a nephrologist at the Mayo Clinic in Rochester, Minn. Dr. Garovic said she was not surprised by the findings. “Although it would be logical to assume that if a woman develops hypertension during pregnancy, she would be hypertensive later in life, prior to this study there were limited data to support this,” she related.


The study population was stratified into three groups: those with pregnancies lasting more than

six months (718 women); those with a normotensive pregnancy (3,421 women); and those with at least one hypertensive pregnancy (643 women). Analyses of cardiovascular outcomes were performed after the women reached age 40, assuming that the chances of another pregnancy were low. Median age was 54 years. Stroke occurred in 5.2% of women who had hypertensive pregnancies and 2.7% of those with normotensive pregnancies. Hypertension occurred in 60.6% and 56.9% and respectively. Microalbuminuria (30 mg or more of albumin in the 24-hour urine collection) was observed in 16.8% and 11.7%, respectively. Women with normotensive pregnancies had lower creatinine levels than those who had pregnancies lasting more than six months.


Hypertension occurred earlier in those who had hypertensive pregnancies. Hypertension developed in half of the hypertensive pregnancy group by age 52 and in half of the normotensive pregnancy group by age 60.


In offering an explanation for the findings, Dr. Garovic suggested that the risk factors for hypertension and CVD are the same. Another possibility is that hypertension during pregnancy leads to vascular and metabolic effects that increase the risk of cardiac and cerebrovascular events and microalbuminuria.