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Hypertensive disorders during pregnancy are strongly associated with cardiovascular mortality after childbirth

Hypertensive disorders during pregnancy are strongly associated with cardiovascular mortality after childbirth

 


Rutgers Health researchers have found that hypertensive disorders during pregnancy are strongly associated with fatal cardiovascular disease during the first year of life.

Some hypertensive diseases that can cause dangerous high blood pressure during pregnancy include: Chronic hypertension, gestational hypertension, preeclampsia without severe features, preeclampsia with severe features, overlap of preeclampsia and eclampsia -; all women except those with gestational diabetes are different from those with normal blood pressure. In comparison, it was associated with a doubled risk of fatal cardiovascular disease.

Eclampsia, a condition in which a hypertensive disorder causes seizures, was associated with an almost 58-fold increase in fatal cardiovascular disease, according to a study published in . Pediatric and perinatal epidemiology.

“Maternal and postpartum mortality rates in the United States are high and rising compared to other high-income countries,” said lead author Rachel Lee, a data analyst at Rutgers University Robert Wood Johnson Medical School. “More than half of cardiovascular disease-related deaths are preventable.” school. “This study provides new information about how each hypertensive disease is associated with deadly cardiovascular disease, and encourages health care providers to more closely monitor patients with such complications. , you can develop strategies to stay healthy postpartum.”

Researchers used the National Readmission Database to examine pregnancy-related mortality rates among women ages 15 to 54 from 2010 to 2018. Data from more than 33 million delivery admissions identified hypertensive disorders in 11 percent of patients, but the number increased over time. In 2010, 9.4 percent of patients in the study had gestational hypertension. By 2018, this number had increased by more than half to 14.4 percent.

As this country becomes better at predicting, diagnosing and treating pre-eclampsia, the risk of death for individual patients with the disease is decreasing. ”


Kande Ananth, chief of the Division of Epidemiology and Biostatistics in the Department of Obstetrics, Gynecology, and Reproductive Sciences at Rutgers Robert Wood Johnson Medical School and senior author of the study, said:

Unfortunately, the rapid increase in the number of patients developing chronic hypertension has more than compensated for the improved ability to treat it, Ananth said.

“Chronic hypertension is rapidly increasing among people of childbearing age, but optimal treatment strategies remain uncertain,” he said. “Although we are treating more pregnant women with mild hypertension with antihypertensive drugs, many questions remain about the correct definition of hypertension in pregnancy compared to non-pregnant women.”

Pregnant women with hypertensive disorders, especially those with a history of hypertension, require high-quality care because heart disease and related cardiac symptoms can be confused with symptoms common in normal pregnancy. Study authors said delayed diagnosis was associated with increased rates of preventable complications. Early detection and optimal treatment of hypertensive disorders, especially preeclampsia and eclampsia, are extremely important for the primary prevention of maternal stroke.

The researchers concluded that guidelines for continued care for up to a year after birth are needed for each hypertensive disease.

sauce:

Reference magazines:

Lee, R. other. (2024). Pregnancy-related mortality due to cardiovascular disease: The impact of hypertensive disorders of pregnancy. Pediatric and perinatal epidemiology. doi.org/10.1111/ppe.13055.

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