Hypertensive Disorders of Pregnancy Tied to Increased Hypertension Risk Decades Later

By Amy Orciari Herman

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

Hypertensive disorders of pregnancy are associated with increased long-term risk for post-pregnancy hypertension, according to two studies in The BMJ.

In the first, researchers used Danish health registries to study over 480,000 women with first pregnancies ending in live birth or stillbirth. Some 5% had hypertensive disorders of pregnancy (e.g., gestational hypertension, pre-eclampsia, eclampsia, HELLP syndrome). The cumulative 10-year incidence of post-pregnancy hypertension among women with such disorders in their twenties, thirties, and forties was 14%, 20%, and 32%, respectively — versus just 4%, 6%, and 11% for those with normotensive pregnancies. In a separate analysis, the increased risk for post-pregnancy hypertension was highest in the year after an affected pregnancy, but it persisted 20 years later.

Separately, in the Nurses' Health Study II, being overweight or obese were the only lifestyle factors that consistently predicted increased risk for chronic hypertension in the decades after gestational hypertension or pre-eclampsia.

Editorialists write, "Findings from both studies reinforce the message that women who have had a pregnancy complicated by any hypertensive disorder should remain under close surveillance for life."