Hypertensive Disorders of Pregnancy Up Early Maternal Mortal
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Chronic hypertension is one of the strongest risk factors for cardiovascular disease (CVD) but might not be the primary pathway through which hypertensive disorders of pregnancy (HDPs) can affect a woman's health and life span.

In a study of more than 88,000 women, published in the Journal of American College of Cardiology, gestational hypertension and pre-eclampsia were associated with a 42% higher age-adjusted risk of dying before age 70.

Between 1989 and 2017, the authors followed 88,395 parous female nurses participating in the Nurses’ Health Study II. The study focused on gestational hypertension and pre-eclampsia within the term HDPs. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between HDPs and premature mortality were estimated by using Cox proportional hazards models, with adjustment for relevant confounders.

Results:
-- The authors documented that 2,387 women died before age 70 years, including 1,141 cancer deaths and 212 CVD deaths.

-- The occurrence of HDPs, either gestational hypertension or pre-eclampsia, was associated with an HR of 1.31 for premature death during follow-up.

-- When specific causes of death were examined, these relations were strongest for CVD-related mortality.

-- The association between HDPs and all-cause premature death persisted, regardless of the subsequent development of chronic hypertension.

Conclusively, an occurrence of HDPs, either gestational hypertension or pre-eclampsia, was associated with an increased risk of premature mortality, particularly CVD mortality, even in the absence of chronic hypertension.

Source: https://www.jacc.org/doi/10.1016/j.jacc.2021.01.018
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