Key result
Preeclampsia and high early-pregnancy SBP are linked to ~50% greater incident CVD risk.
Why the study?
Preeclampsia is a recognized risk factor for long-term CVD, but evidence is limited regarding the risk associated with high blood pressure in early pregnancy.
Do high blood pressure in early pregnancy and preeclampsia increase the risk of incident cardiovascular disease in mothers?
Cohort (n=2,434)
Do high blood pressure in early pregnancy and preeclampsia increase the risk of incident cardiovascular disease in mothers?
High systolic blood pressure in early pregnancy is a significant risk factor for long-term maternal cardiovascular disease, comparable in magnitude to a history of preeclampsia.
Answers are grounded in this paper and cite their sources.
Early pregnancy hypertension signals elevated maternal CVD risk; extends preeclampsia data but observational design leaves causal effects and practice change open.
OBJECTIVES: Studies suggest preeclampsia as a risk factor for long term cardiovascular diseases (CVD), while evidence is limited regarding the risk of high blood pressures (BP) in early pregnancy. STUDY DESIGN: A register-based follow-up of 2434 mothers in the Helsingborg Birth Cohort. Associations of high BP in early pregnancy (>95th percentile systolic [SBP], diastolic [BDP], or mean arterial BP [MAP]) during the first antenatal visit and/or preeclampsia with an incident CVD event (ischemic heart disease or stroke) were assessed. To model risks and adjust for co-variables, Cox proportional hazard regression was used. RESULTS: Of the included women, 120 (4.9%) had high SBP, 49 (2%) high DBP, 104 (4.3%) high MAP in early pregnancy; and 115 (4.7%) developed preeclampsia. During 52 years of follow-up, totalling 121,457 person-years, 534 (21.9%) women experienced a CVD event. Women with preeclampsia had a higher risk of developing CVD compared to women without preeclampsia (HR 1.5, 95%CI: 1.1-2.2), while risks among women with high BPs were slightly higher. In adjusted analysis, risk estimates were approximately 50% higher than that of the reference groups for all four studied exposures. Of women with later CVD, 35 (6.6%) had preeclampsia, and another 31 (5,8%) women high SBP or high MAP. Without later preeclampsia, high SBP constituted a significant risk factor (HR 1.6, 95%CI: 1.1-2.4) for CVD. CONCLUSIONS: Women with SBP > 95th percentile in early pregnancy, but without later preeclampsia, have a higher risk of developing CVD that is comparable to women with history of preeclampsia.
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Sharma et al. (2021) conducted a cohort in Preeclampsia and high blood pressure in early pregnancy (n=2,434). Preeclampsia and/or high blood pressure in early pregnancy vs. Women without preeclampsia or high blood pressure was evaluated on Incident CVD event (ischemic heart disease or stroke) (HR 1.5, 95% CI 1.1-2.2). Preeclampsia and high systolic blood pressure in early pregnancy without later preeclampsia were significant risk factors for cardiovascular disease.
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