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Hypertensive Disorders of Pregnancy Linked to Premature Mortality

TUESDAY, March 9, 2021 -- Hypertensive disorders of pregnancy (HDPs) are associated with an increased subsequent risk for premature mortality, according to a study published in the March 16 issue of the Journal of the American College of Cardiology.

Yi-Xin Wang, M.D., Ph.D., from the Harvard T.H. Chan School of Public Health in Boston, and colleagues followed 88,395 parous female nurses participating in the Nurses' Health Study II to examine whether HDPs are associated with premature mortality, while focusing on gestational hypertension and preeclampsia.

The researchers found that 2,387 women died before age 70 years, with 1,141 cancer deaths and 212 cardiovascular disease (CVD) deaths. There was an association seen for occurrence of HDPs, either gestational hypertension or preeclampsia, with premature death during follow-up, with a hazard ratio of 1.31. These associations were strongest for CVD-related mortality (hazard ratio, 2.26) on examination of specific causes of death. Regardless of the subsequent development of chronic hypertension, the association between HDPs and all-cause premature death persisted (hazard ratios, 1.20 for HDPs only and 2.02 for HDPs and subsequent chronic hypertension).

"[The authors] should be applauded on raising a biologic plausibility of the independent association of HDPs with premature all-cause mortality," write the authors of an accompanying editorial. "Contemporary management of women with HDPs will need better risk assessment tools informed by precision medicine to appropriately identify those women who are at greatest risk of premature CVD and to develop algorithms for early intervention to change the trajectory of these women."

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