Cardiovascular Disease Risk Factors After Early-Onset Preeclampsia, Late-Onset Preeclampsia, and Pregnancy-Induced Hypertension

TLDR

Observational studies link hypertensive disorders of pregnancy to a higher lifetime risk of cardiovascular disease, with risk increasing with disease severity and earlier gestational onset. The study aimed to determine whether these differences in cardiovascular risk factors are evident at postpartum cardiovascular screening. Researchers compared the prevalence of common cardiovascular risk factors postpartum among 448 women with early‑onset preeclampsia, 76 with late‑onset preeclampsia, and 224 with pregnancy‑induced hypertension. Women with early‑onset preeclampsia exhibited higher fasting glucose, insulin, triglycerides, and total cholesterol, and nearly half had hypertension compared to 39% and 25% in the other groups, indicating that postpartum risk factor profiles differ by severity and gestational age and should guide stratified prevention strategies.

Abstract

Observational studies have shown an increased lifetime risk of cardiovascular disease (CVD) in women who experienced a hypertensive disorder in pregnancy. This risk is related to the severity of the pregnancy-related hypertensive disease and gestational age at onset. However, it has not been investigated whether these differences in CVD risk factors are already present at postpartum cardiovascular screening. We evaluated postpartum differences in CVD risk factors in 3 subgroups of patients with a history of hypertensive pregnancy. We compared the prevalence of common CVD risk factors postpartum among 448 women with previous early-onset preeclampsia, 76 women with previous late-onset preeclampsia, and 224 women with previous pregnancy-induced hypertension. Women with previous early-onset preeclampsia were compared with women with late-onset preeclampsia and pregnancy-induced hypertension and had significantly higher fasting blood glucose (5.29 versus 4.80 and 4.83 mmol/L), insulin (9.12 versus 6.31 and 6.7 uIU/L), triglycerides (1.32 versus 1.02 and 0.97 mmol/L), and total cholesterol (5.14 versus 4.73 and 4.73 mmol/L). Almost half of the early-onset preeclampsia women had developed hypertension, as opposed to 39% and 25% of women in the pregnancy-induced hypertension and late-onset preeclampsia groups, respectively. Our data show differences in the prevalence of common modifiable CVD risk factors postpartum and suggest that prevention strategies should be stratified according to severity and gestational age of onset for the hypertensive disorders of pregnancy.