Aims: Gestational hypertension (GH) is a common complication of pregnancy and is associated with increased risk of incident hypertension in later life (IH) and cardiovascular events. However, the interactive effect ofGHand IH on postpartum cardiovascular health remains unclear. Methods and results: A nationwide population-based study was conducted using one million individuals from the Taiwan National Health Insurance database. Records from 1997 to 2009 were used to identify 1303 pregnant women with GH and without previous cardiovascular disease. The control group comprised 5212 pregnant women without GH, matched for age and date of delivery. During the follow-up period (median duration, 5.8 years), 170 cardiovascular events developed.Women with GH had significantly higher risk of cardiovascular events (hazard ratio [95% confidence interval], 3.37 [2.48–4.58]) and IH (6.93 [5.38–8.92]) than controls. Compared with women without GH or IH, there was a significantly higher risk of cardiovascular events for women without GH but with IH (relative risk [95% confidence interval], 2.24 [1.54–3.25]), women with GH but without IH (3.94 [1.87–8.32]), and women with GH and IH (14.75 [9.57–22.74]). The synergy index was 3.29 (95% confidence interval, 1.47–7.40), suggesting a positive interaction between GH and IH.Conclusions: GH increased the risk of subsequent IH.Women with both GH and IH were more at risk of cardiovascular events than women with either GH or IH. The synergistic adverse effect of GH and IH on postpartum cardiovascular health indicates that more attention should be paid to this population.
Date:
2014-09
Relation:
European Heart Journal. 2014 Sep;35(Suppl. 1):368.
