Pregnancy-Induced Hypertensive Disorder and Risks of Future Ischemic and Nonischemic Heart Failure.
JACC Heart Fail
; 11(9): 1216-1228, 2023 09.
Article
in En
| MEDLINE
| ID: mdl-37178088
ABSTRACT
BACKGROUND:
Although adverse pregnancy outcomes are associated with an increased risk of cardiovascular disease, studies on timing and subtypes of heart failure after a hypertensive pregnancy are lacking.OBJECTIVES:
The goal of this study was to assess the association between pregnancy-induced hypertensive disorder and risk of heart failure, according to ischemic and nonischemic subtypes, and the impact of disease characteristics and the timing of heart failure risks.METHODS:
This was a population-based matched cohort study, comprising all primiparous women without a history of cardiovascular disease included in the Swedish Medical Birth Register between 1988 and 2019. Women with pregnancy-induced hypertensive disorder were matched with women with normotensive pregnancies. Through linkage with health care registers, all women were followed up for incident heart failure, classified as ischemic or nonischemic.RESULTS:
In total, 79,334 women with pregnancy-induced hypertensive disorder were matched with 396,531 women with normotensive pregnancies. During a median follow-up of 13 years, rates of all heart failure subtypes were more common among women with pregnancy-induced hypertensive disorder. Compared with women with normotensive pregnancies, adjusted HRs (aHRs) with 95% CIs were as follows heart failure overall, aHR 1.70 (95% CI 1.51-1.91); ischemic heart failure, aHR 2.28 (95% CI 1.74-2.98); and nonischemic heart failure, aHR 1.60 (95% CI 1.40-1.83). Disease characteristics indicating severe hypertensive disorder were associated with higher heart failure rates, and rates were highest within the first years after the hypertensive pregnancy but remained significantly increased thereafter.CONCLUSIONS:
Pregnancy-induced hypertensive disorder is associated with an increased short-term and long-term risk of incident ischemic and nonischemic heart failure. Disease characteristics indicating more severe forms of pregnancy-induced hypertensive disorder amplify the heart failure risks.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Cardiovascular Diseases
/
Hypertension, Pregnancy-Induced
/
Heart Failure
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Pregnancy
Country/Region as subject:
Europa
Language:
En
Year:
2023
Type:
Article