From the Guidelines
Yes, pre-eclampsia does predispose women to hypertension later in life. According to the most recent and highest quality study, women with pre-eclampsia have a 3.7-fold risk of hypertension, 2.2-fold risk of ischemic heart disease, 1.8-fold risk of stroke, and 1.5-fold risk of overall mortality after 10 to 15 years 1. This increased risk becomes evident as early as the first year after delivery and persists for decades. The relationship appears to be dose-dependent, with more severe pre-eclampsia, early-onset disease, or recurrent pre-eclampsia carrying even higher risks for future hypertension.
Key Findings
- Women with pre-eclampsia are at increased risk of developing chronic hypertension, ischemic heart disease, stroke, and overall mortality 1.
- The risk of hypertension after pre-eclampsia is approximately 3.7-fold higher compared to women with normotensive pregnancies 1.
- Lifestyle modifications, including maintaining a healthy weight, regular physical activity, limiting sodium intake, and following a heart-healthy diet, are crucial for women with a history of pre-eclampsia to reduce their cardiovascular risk 1.
Recommendations
- Women with a history of pre-eclampsia should receive regular blood pressure monitoring after delivery, with annual checks recommended even if blood pressure normalizes postpartum.
- Healthcare providers should consider a history of pre-eclampsia as a significant cardiovascular risk factor when assessing women's long-term health needs.
- Lifestyle modifications and regular monitoring can help reduce the risk of cardiovascular disease in women with a history of pre-eclampsia.
From the Research
Pre-eclampsia and Hypertension
- Pre-eclampsia is a condition characterized by high blood pressure and proteinuria during pregnancy, affecting 2-8% of pregnancies 2.
- Studies have shown that pre-eclampsia may be a risk marker for later-life diseases, including cardiovascular and renal diseases, and the metabolic syndrome 3, 4.
- Women who have had pre-eclampsia are at increased risk of chronic hypertension, with a prevalence of hypertension defined by office blood pressure ≥140/90 mmHg or ongoing antihypertensive treatment being 35% 3.
Cardiovascular Risk Factors
- Pre-eclampsia has been linked to an increased risk of cardiovascular disease, with women having a two to five times higher risk compared to those with uncomplicated pregnancies 5.
- The risk of cardiovascular disease in women with pre-eclampsia persists even after adjusting for known cardiovascular risk factors, including albuminuria 5.
- Women with a history of severe pre-eclampsia have higher rates of previous cardiovascular disease and are at a threefold higher risk of cardiovascular disease compared to those without pre-eclampsia 5.
Long-term Maternal Health
- Pre-eclampsia can have long-term effects on maternal health, with women being at increased risk of chronic hypertension, ischemic heart disease, cerebrovascular disease, kidney disease, diabetes mellitus, thromboembolism, hypothyroidism, and impaired memory 4.
- The risk of these conditions is thought to be related to the underlying endothelial dysfunction and inflammation that occurs during pre-eclampsia 4.