Chronic hypertension increases CVD risk as early as 1 month after childbirth

Key takeaways:

• CVD hospitalization rates were higher for postpartum women with chronic hypertension vs. normotensive women.
• CVD hospital readmission risk related to chronic hypertension remained for up to 1 year postpartum.

Postpartum women with chronic hypertension have an increased risk for CVD within the first year after childbirth, according to study results published in Obstetrics & Gynecology.

“Chronic hypertension is a serious condition that cannot be ignored,” Cande V. Ananth, PhD, MPH, professor, vice chair for academic affairs and chief of the division of epidemiology and biostatistics in the department of obstetrics, gynecology and reproductive sciences at Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, told Healio. “Timely diagnosis and optimal treatment remain essential to reduce the burden of CVD risks in the postpartum period.”

Ananth and colleagues conducted a population-based retrospective cohort study using data from the Healthcare Cost and Utilization Project’s Nationwide Readmission Database. Researchers evaluated data from 27,395,346 singleton birth delivery hospitalizations from patients aged 15 to 54 years from 2010 to 2018. Researchers identified women with chronic hypertension and postpartum hospital readmission due to CVD complications within 1 year after childbirth. With this information, researchers estimated excess rates of CVD readmission among women with and without chronic hypertension.

Overall, 2% of women in the cohort had chronic hypertension. The CVD hospitalization rate among women with chronic hypertension was 645 per 100,000 delivery hospitalizations compared with 136 per 100,000 delivery hospitalizations among normotensive women (adjusted HR = 4.11; 95% CI, 3.64-4.66). Increased hospital readmissions among women with chronic hypertension were also observed for hospital readmissions for any heart disease (aHR = 4.45; 95% CI, 3.89-5.1) and any stroke (aHR = 2.32; 95% CI, 1.93-2.79).

Risk for CVD hospital readmissions related to chronic hypertension was seen within the first 30 days postpartum and progressively increased within the first year after childbirth.

“[We need research on] whether the increased CVD stress of pregnancy in individuals with chronic hypertension irreversibly worsens cardiac status compared with patients that were never pregnant and whether closer postpartum surveillance can mitigate the risk of CVD,” Ananth said.

For more information:

Cande V. Ananth, PhD, MPH, can be reached at ananthcv@rwjms.rutgers.edu.