Early Mortality, Cardiovascular, and Renal Diseases in Women's Lives Following Hypertensive Disorders of Pregnancy: The Prospective Nationwide Study CONCEPTION.

Abstract

BACKGROUND:

We aimed to evaluate the impact of hypertensive disorders of pregnancy occurrence, recurrence, onset time, and severity on mortality and on a wide range of cardiovascular outcomes in France.

METHODS AND RESULTS:

CONCEPTION (Cohort of Cardiovascular Diseases in Pregnancy) is a French nationwide prospective cohort using data from the National Health Data System. We included all women in CONCEPTION with no history of a cardiovascular event who delivered in France for the first time between 2010 and 2018 (N=2 819 655). Hypertensive disorders of pregnancy and cardiovascular outcomes during the study follow-up were identified using algorithms combining International Classification of Diseases, Tenth Revision (ICD-10) coded diagnoses during hospitalization and purchases of medication between 2010 and 2021. We fitted Cox models with time-varying exposure to assess the associations of hypertensive disorders of pregnancy with mortality and cardiovascular events. Women with gestational hypertension had a 1.25- to 2-fold higher risk of stroke, acute coronary syndrome, peripheral arterial disease, pulmonary embolism, and chronic kidney disease, and a 2- to 4-fold higher risk of rhythm and conduction disorder and heart failure. Women with preeclampsia had a 1.35- to 2-fold higher risk of rhythm or conduction disorder and pulmonary embolism during follow-up; a 2- to 4-fold higher risk of stroke, acute coronary syndrome, and peripheral arterial disease; and a 7- to 9-fold higher risk of heart failure and chronic kidney disease. They were 1.8 times more likely to die and 4.4 times more likely to die of cardiovascular causes.

CONCLUSIONS:

Hypertensive disorders of pregnancy drastically increase the risk of mortality, cardiovascular, and renal events early after pregnancy. Recurrent, severe, and early-onset preeclampsia further increases this risk.

• Authors: Grégory Lailler, Clémence Grave, Amélie Gabet, Pierre Joly, Nolwenn Regnault, Catherine Deneux-Tharaux, Vassilis Tstsaris, Geneviève Plu-Bureau, Sandrine Kretz, Jacques Blacher, Valérie Olie
• Journal: Journal of the American Heart Association (J Am Heart Assoc) Vol. 13 Issue 8 Pg. e033252 (Apr 16 2024) ISSN: 2047-9980 [Electronic] England
• PMID: 38563390 (Publication Type: Journal Article)

Topics

• Pregnancy
• Female
• Humans
• Hypertension, Pregnancy-Induced (diagnosis, epidemiology)
• Pre-Eclampsia (epidemiology, diagnosis)
• Prospective Studies
• Acute Coronary Syndrome
• Cardiovascular Diseases (diagnosis, epidemiology)
• Heart Failure
• Renal Insufficiency, Chronic (epidemiology)
• Stroke
• Pulmonary Embolism
• Peripheral Arterial Disease