Hypertensive disorders during pregnancy increase cardiovascular risk of death after giving birth: Study

A study by Rutgers Health has found out that hypertensive problems during pregnancy increase cardiovascular risk of death up to a year after giving birth.

Researchers at Rutgers Health discovered that hypertensive problems during pregnancy are substantially related to deadly cardiovascular disease up to a year after birth. All hypertensive disorders that cause dangerously high blood pressure during pregnancy--chronic hypertension, gestational hypertension, preeclampsia without severe features, preeclampsia with severe features, superimposed preeclampsia, and eclampsia--except gestational diabetes, were associated with a doubling in the risk of fatal cardiovascular disease compared to women with normal blood pressure.

Eclampsia, a syndrome in which hypertension issues cause seizures, was linked to a roughly 58-fold increase in fatal cardiovascular disease, according to a study published in Paediatric and Perinatal Epidemiology.

"Maternal and postpartum mortality rates in the US are higher than in other high-income countries and rising, but more than half of cardiovascular disease-related deaths are preventable," said lead author Rachel Lee, a data analyst at Rutgers Robert Wood Johnson Medical School. "This study provides new information about how each hypertensive disorder is related to fatal cardiovascular disease, so healthcare providers can monitor patients with such complications more closely and develop strategies for keeping them healthy postpartum."

"We've gotten better at predicting, diagnosing, and treating preeclampsia in this country, so the risk of death is falling for any individual patient with that condition," said Cande Ananth, chief of the Division of Epidemiology and Biostatistics in the Department of Obstetrics, Gynecology, and Reproductive Sciences at Rutgers Robert Wood Johnson Medical School and senior author of the study.

Unfortunately, Ananth noted, the sharp increase in the number of patients who develop chronic hypertension has more than offset the improved ability to treat it.

"Cases of chronic hypertension are rising sharply among people of childbearing age, but optimal treatment strategies remain uncertain," he said. "While we're treating more pregnant people with mild hypertension with antihypertensive medications, there remain many questions about the right definitions of hypertension in pregnant compared to non-pregnant individuals."

Pregnant people with hypertensive disorders, especially those with pre-existing hypertension, need high-quality care as heart disease and related cardiac symptoms can be confused with common symptoms of normal pregnancy. Delays in diagnosis are associated with an increased incidence of preventable complications, the study authors said. Early identification and optimal treatment of hypertensive disorders, especially preeclampsia-eclampsia, are crucial for the primary prevention of maternal stroke.

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