High BP during pregnancy increases later CVD risk by more than 70%: JAMA

High Blood pressure, BP during pregnancy increases later CVD risk by more than 70%, finds a JAMA study.

High Blood pressure, BP and Body Mass Index, BMI during pregnancy are linked to a 77% increased risk of cardiovascular disease in women in later life. Therefore a history of hypertensive disorders of pregnancy, HDP calls for more aggressive follow-up in all such women for the development of cardiovascular disorders. The study has appeared in the JAMA Cardiology.

The study aimed at evaluating the risk of cardiovascular disease in the presence of conventional cardiovascular risk factors in pregnant women.

The authors conducted a prospective cohort study with an average follow-up of 18 years. A population-based cohort of women participating in the Nord-Trøndelag Health Study in Norway. They linked data for 31 364 women from the Nord-Trøndelag Health Study (1984-2008) to validated hospital records (1987-2015), the Cause of Death Registry (1984-2015), and the Medical Birth Registry of Norway (1967-2012). A total of 7399 women were excluded based on selected pregnancy characteristics, incomplete data, or because of emigrating or experiencing the endpoint before the start of follow-up, leaving 23 885 women for the study. Data were analyzed between January 1, 2018, and June 6, 2018. The selected criteria were: women experiencing 1 or more pregnancies complicated by hypertensive disorders of pregnancy, HDP before age 40 years vs only experiencing normotensive pregnancies.

The authors have used Cox proportional hazards models to estimate the hazard ratios (HRs) for the association between hypertensive disorders of pregnancy, HDP and CVD. The proportion of excess risk associated with conventional cardiovascular risk factors was estimated using an inverse odds ratio weighting approach.

Main findings of the study

• The study population consisted of 23 885 parous women from Nord-Trøndelag County, Norway.


• The study population consisted of 23 885 parous women from Nord-Trøndelag County, Norway.


• A total of 21 766 women had only normotensive pregnancies i.e normal blood pressure during pregnancy, while 2199 women experienced ever having an HDP.


• From age 40 to 70 years, women with a history of HDP i.e, abnormal blood pressure during pregnancy, had an increased risk of CVD compared with women with only normotensive pregnancies.


• Blood pressure and body mass index were associated with up to 77% of the excess risk of CVD in women with a history of HDP, while glucose and lipid levels were associated with smaller proportions.

The authors concluded that the risk of excess CVD in women with a history of pregnancy, HDP was associated with conventional cardiovascular risk factors, indicating that these risk factors are important targets for cardiovascular prevention in these women.

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doi:10.1001/jamacardio.2019.1746