Risk: High Blood Pressure in Pregnancy

Women who develop even mild high blood pressure during pregnancy may be more likely to have heart disease later in life, according to a new study.

Doctors usually assume that developing high blood pressure during pregnancy has no long-term consequences and will merely go away once the baby is born.

The new study suggests this may not be true.

As a result, women who have high blood pressure while pregnant may require early intervention to protect their hearts.

"Our research and that of others may have important implications for the management of women who have high blood pressure in pregnancy," concludes study researcher Michiel L. Bots, MD, PhD, in a written statement. Bots is an associate professor of epidemiology at the Julius Center for Health Sciences and Primary Care in Utrecht, The Netherlands.

The study appears in the February issue of Hypertension: Journal of the American Heart Association.

Heart Disease Later

In the study of 491 postmenopausal women, almost 31% said they had high blood pressure when they were pregnant.

This information came from questionnaires given when the women were postmenopausal, with an average age of 67 years, so their recall may not have been 100% accurate.

The women underwent a test to measure the amount of calcium buildup in their coronary arteries. Calcium buildup in the heart arteries is a marker for heart disease risk from coronary artery disease.

Those women who said they had had high blood pressure during pregnancy were 57% more likely to have calcium buildup in their arteries than women who did not report high blood pressure during pregnancy, the study showed.

The findings held in women who had mild elevations in blood pressure as well as those who developed preeclampsia, a serious pregnancy complication marked by extremely high blood pressure and swelling and protein leakage in urine.

Predictive Value

Pregnancy may function as a test of later-in-life heart function, the researchers suggest. High blood pressure during pregnancy could have a positive aspect, identifying women who are at risk for heart disease in the future.

"These women might benefit from cardiovascular risk factor management, starting soon after pregnancy, at an age when they are more likely to benefit from secondary prevention," the researchers say.

Women who reported high blood pressure while pregnant also had increased body mass index and increased diastolic blood pressure (the lower number in a blood pressure reading), the study showed.

More Follow-up Needed

"Women should be encouraged to follow up with their gynecologist yearly, [and] at their annual exam, their blood pressure and weight should be measured," Geeta Sharma, MD, tells WebMD.

"More follow-up will be dictated by their blood pressure and cholesterol levels at their annual exam," says Sharma, an assistant professor of obstetrics and gynecology at New York-Presbyterian Hospital/Weill Cornell Medical Center in New York City. "Controllable risk factors, such as diet, weight loss and exercise should be addressed."

Unfortunately, Sharma says, "many women seek medical care only when pregnant and then do not find time for themselves as they prioritize the health of their family. It is very important that they continue seeing their doctor at least annually. "




SOURCES: Sabour, S. Hypertension, 2007; vol 49: pp 1-2. Michiel L. Bots, MD, PhD, associate professor of epidemiology at the Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands. Geeta Sharma, MD, assistant professor of obstetrics and gynecology and assistant attending obstetrician and gynecologist, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York City.


By Denise Mann
Reviewed by Louise Chang

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