Synergistic effect of gestational hypertension and postpartum incident hypertension on cardiovascular health

A nationwide population study

Jong Shiuan Yeh, Hao Min Cheng, Pai Feng Hsu, Shih Hsien Sung, Wen Ling Liu, Hsin Ling Fang, Shao Yuan Chuang

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background-Gestational hypertension (GH) is a common complication of pregnancy and is associated with increased risk of incident hypertension in later life (IH) and cardiovascular events. However, the interactive effect of GH and IH on postpartum cardiovascular health remains unclear. Methods and Results-A nationwide population-based study was conducted using 1 million individuals from the Taiwan National Health Insurance database. Records from 1998 to 2009 were used to identify 1260 pregnant women with GH and without previous cardiovascular disease. The control group comprised 5040 pregnant women without GH, matched for age and date of delivery. During the follow-up period (median duration, 5.8 years), 182 cardiovascular events developed. Women with GH had significantly higher risk of cardiovascular events (hazard ratio [95% CI], 2.44 [1.80 to 3.31]) and IH (8.29 [6.30 to 10.91]) than controls. Compared with women without GH and IH, there was a significantly higher risk of cardiovascular events for women without GH but with IH (relative risk [95% CI], 2.89 [1.27-6.58]), women with GH but without IH (1.66 [1.16-2.39]), and women with GH and IH (8.11 [5.36-12.30]). The synergy index was 2.91 (95% CI 1.11 to 7.59), suggesting a positive interaction between GH and IH. Conclusions-GH increased the risk of subsequent IH. Women with both GH and IH were at a substantially higher cardiovascular risk than were women with either GH or IH. The synergistic adverse effect of GH and IH on postpartum cardiovascular health indicates that more attention should be paid to this special population.

Original languageEnglish
Article number001008
JournalJournal of the American Heart Association
Volume3
Issue number6
DOIs
Publication statusPublished - 2014

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Pregnancy Induced Hypertension
Postpartum Period
Hypertension
Health
Population
Pregnant Women
Pregnancy Complications
National Health Programs
Taiwan

Keywords

  • Cardiovascular events
  • Gestational hypertension
  • Incident hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Synergistic effect of gestational hypertension and postpartum incident hypertension on cardiovascular health : A nationwide population study. / Yeh, Jong Shiuan; Cheng, Hao Min; Hsu, Pai Feng; Sung, Shih Hsien; Liu, Wen Ling; Fang, Hsin Ling; Chuang, Shao Yuan.

In: Journal of the American Heart Association, Vol. 3, No. 6, 001008, 2014.

Research output: Contribution to journalArticle

Yeh, Jong Shiuan ; Cheng, Hao Min ; Hsu, Pai Feng ; Sung, Shih Hsien ; Liu, Wen Ling ; Fang, Hsin Ling ; Chuang, Shao Yuan. / Synergistic effect of gestational hypertension and postpartum incident hypertension on cardiovascular health : A nationwide population study. In: Journal of the American Heart Association. 2014 ; Vol. 3, No. 6.
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abstract = "Background-Gestational hypertension (GH) is a common complication of pregnancy and is associated with increased risk of incident hypertension in later life (IH) and cardiovascular events. However, the interactive effect of GH and IH on postpartum cardiovascular health remains unclear. Methods and Results-A nationwide population-based study was conducted using 1 million individuals from the Taiwan National Health Insurance database. Records from 1998 to 2009 were used to identify 1260 pregnant women with GH and without previous cardiovascular disease. The control group comprised 5040 pregnant women without GH, matched for age and date of delivery. During the follow-up period (median duration, 5.8 years), 182 cardiovascular events developed. Women with GH had significantly higher risk of cardiovascular events (hazard ratio [95{\%} CI], 2.44 [1.80 to 3.31]) and IH (8.29 [6.30 to 10.91]) than controls. Compared with women without GH and IH, there was a significantly higher risk of cardiovascular events for women without GH but with IH (relative risk [95{\%} CI], 2.89 [1.27-6.58]), women with GH but without IH (1.66 [1.16-2.39]), and women with GH and IH (8.11 [5.36-12.30]). The synergy index was 2.91 (95{\%} CI 1.11 to 7.59), suggesting a positive interaction between GH and IH. Conclusions-GH increased the risk of subsequent IH. Women with both GH and IH were at a substantially higher cardiovascular risk than were women with either GH or IH. The synergistic adverse effect of GH and IH on postpartum cardiovascular health indicates that more attention should be paid to this special population.",
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