Early pregnancy heart health important in preventing gestational hypertension
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Key takeaways:
- Frist-trimester CV health was linked to reduced risk for hypertensive disorders of pregnancy.
- BMI, BP and diet had the largest impact on population-attributable risk for hypertensive disorders of pregnancy.
Optimal heart health during the first trimester of pregnancy was associated with lower risk for hypertensive disorders of pregnancy, a speaker reported.
Vineetha Mathew, a fourth-year MD candidate at Tufts University School of Medicine, presented the results of an study that evaluated whether first-trimester CV health could mitigate genetic risk for hypertensive disorders of pregnancy at the Hypertension Scientific Sessons.
“We were looking to see if there was an association between cardiovascular health during early pregnancy and risk of developing a hypertensive disorder of pregnancy such as preeclampsia or gestational hypertension, even across genetic risk groups for these diseases,” Mathew said in a press release. “Our results found that across all genetic risk groups, better first trimester cardiovascular health may partially mitigate the risk of adverse pregnancy outcomes and the risk of developing hypertensive disorders of pregnancy.”
The analysis included 5,446 genotyped participants in the nuMoM2b study (mean age, 28 years).
Genetic risk and CV health were calculated using a validated polygenic risk score and score adapted from the AHA’s Life’s Essential 8, respectively, and participants were grouped as low, intermediate and high risk.
Overall, 6.3% of patients developed preeclampsia and 18.3% had gestational hypertension.
The researchers reported that higher calculated genetic risk and lower CV health score were additively associated with risk for hypertensive disorders of pregnancy with no significant interaction.
Incidence of hypertensive disorders of pregnancy ranged from 11% among those with low genetic risk and high first-trimester CV health to 37% among those with high genetic risk and low first-trimester CV health, according to the presentation. Favorable first-trimester CV health was associated with 35% to 62% lower risk for hypertensive disorders of pregnancy compared with unfavorable CV health.
“What was really interesting about our findings was how cardiovascular health in the first trimester appeared to be protective for all. We saw that the odds of developing a hypertensive disorder of pregnancy among those with a high genetic risk combined with favorable cardiovascular health was comparable or even better than those with low genetic risk but unfavorable cardiovascular health,” Mathew said in the release.
Moreover, nonideal BMI, BP and diet had the largest impact on population-attributable risk for hypertensive disorders of pregnancy, at 25%, 14% and 12%, respectively.
“Based on our research, we want to underscore the importance of preconception and early pregnancy cardiovascular health counseling. OB-GYN and primary care professionals should emphasize cardiovascular health improvement, healthier nutrition, weight management and healthy blood pressure to patients who are considering pregnancy,” Mathew said in the release. “Prevention is becoming the forefront of medicine. Start early, even before pregnancy, when you are just considering pregnancy. We want to target cardiovascular health at that stage because it can have an impact on pregnancy outcomes and on later-life cardiovascular disease.”
Reference:
- Better cardiovascular health in early pregnancy may offset high genetic risk. https://newsroom.heart.org/news/better-cardiovascular-health-in-early-pregnancy-may-offset-high-genetic-risk. Published Sept. 7, 2024. Accessed Sept. 23, 2024.
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Mathew V, et al. Oral Presentation 48. Presented at: Hypertension Scientific Sessions; Sept. 5-8, 2024; Chicago.
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