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Hypertension during pregnancy increases risk for CV readmission
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Women with hypertensive disorders of pregnancy, including gestational hypertension, preeclampsia and eclampsia, had an increased risk for CV readmission during the 3 years after delivery, especially in black women, according to a study published in Heart.
“These findings and the results of our study demonstrate increased CV risk in women with [hypertensive disorders of pregnancy] beginning soon after delivery and persisting decades later,” Jennifer L. Jarvie, MD, instructor/fellow in the division of cardiology at University of Colorado School of Medicine in Aurora, and colleagues wrote.
Researchers analyzed administrative hospital discharge data from 1,452,926 women (mean age, 27 years; 52% white; 23% black; 18% Hispanic) who delivered their first child between 2004 and 2010.
The primary outcome was CV readmission within 3 years of delivery. Secondary outcomes included non-CV readmission, all-cause readmission and time to first readmission.
During follow-up, 4,054 CV admissions and 259,252 non-CV readmissions occurred. Women with hypertensive disorders of pregnancy had higher CV event rates compared with women without the disorders (6.4 CV readmissions per 1,000 deliveries vs. 2.5 CV readmission per 1,000 deliveries; P < .001).
More than half of CV readmissions occurred in black women (57%). The event rate in black women was 6.8 CV readmissions per 1,000 deliveries, compared with 1.7 CV readmissions per 1,000 deliveries in white women and 1 CV readmission per 1,000 deliveries in Hispanic women (P < .001).
After adjustment, women with hypertensive disorders of pregnancy had an increased risk for CV readmission (OR = 2.41; 95% CI, 2.05-2.8) or any readmission (OR = 1.13; 95% CI, 1.1-1.15).
The highest risk for CV readmission was seen in black women (OR = 3.6; 95% CI, 3.32-3.9) compared with white women, and Hispanic women had the lowest risk (OR = 0.59; 95% CI, 0.51-0.68) after adjusting for hypertensive disorders of pregnancy.
“Women with pregnancies complicated by [hypertensive disorders of pregnancy] can be risk stratified, educated and followed more closely by health care providers for CV risk factor management while ongoing efforts continue to learn more about the timing, pathophysiology and types of CV events these women experience,” Jarvie and colleagues wrote. – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.
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