American Journal of Obstetrics & Gynecology: Published: April, 2023

Hypertensive disorders in pregnancy (HDPs) are major causes of maternal and fetal morbidity and are associated with future maternal risk of cardiovascular disease.

Most existing data on hypertensive disorders of pregnancy and short-term cardiovascular disease risks are limited to the immediate postpartum period; however, it is crucial to determine cardiovascular disease risk up to 24 months after delivery to inform cardiovascular disease screening protocols during the extended postpartum period.

This longitudinal population-based study examined the risk of cardiovascular diagnoses within 24 months of delivery among individuals with hypertensive disorders during pregnancy compared with patients without hypertensive disorders of pregnancy.

TAKE-HOME MESSAGE

Hypertensive disease of pregnancy was associated with an increased risk of heart failure, cerebrovascular disease, cardiomyopathy, and severe cardiac disease.

Hypertensive disorders of pregnancy increased the risk of new chronic hypertension. There was no increased risk of ischemia, cardiac arrest, or arrhythmias.

Monitoring for heart failure, cerebrovascular disease, and cardiomyopathy in postpartum patients who had hypertensive disorders of pregnancy could result in fewer adverse outcomes associated with these conditions.

In addition, ensuring follow-up blood pressure management will help reduce the cardiovascular risk of untreated hypertension.

CONCLUSION

Patients with hypertensive disorders of pregnancy had an increased risk of developing new chronic hypertension, heart failure, cerebrovascular disease, and cardiomyopathy within 24 months after delivery.

There was no association between hypertensive disorders of pregnancy and ischemic heart disease or cardiac arrest or arrhythmia.

Patients with hypertensive disorders of pregnancy need targeted early postpartum interventions and increased monitoring in the first 24 months after delivery.

This may preserve long-term health and improve maternal and neonatal outcomes in a subsequent pregnancy.