High BP in pregnancy ups risk of heart disease

Women who develop severe high blood pressure while pregnant, a condition known as gestational hypertension, face a higher risk of developing ischemic heart disease later in life, researchers from Sweden report. Heart disease involving ischemia is characterized by restricted blood flow to the coronary arteries.

Previous studies have shown a variety of associations between preeclampsia - a condition of pregnancy marked by high blood pressure, fluid retention and protein in urine - and cardiovascular ills later life. This led researchers to hypothesize that the severity of the gestational hypertensive disorder may correlate with the risk for later development of ischemic heart disease.

To investigate, Dr. Anna-Karin Wikstrom from Uppsala University and colleagues compared the rates of hospitalization for, or death from, ischemic heart disease in more than 400,000 women. More than 20,000 developed hypertensive disease during their first pregnancy and 2000 had recurrent hypertensive disease.

Overall, the risk of being hospitalized for or dying from heart disease was 60 percent higher for women with gestational hypertension, 90 percent higher for women with mild preeclampsia, and 180 percent higher for women with severe preeclampsia than for women with normal pregnancies, the authors report.

But they emphasize that the "absolute risk is still small," noting that the overwhelming majority of cases (89 percent) of ischemic heart disease have no previous history of gestational hypertension.

"We do not therefore consider that information about this increased risk of developing ischemic heart disease should be given to all women with gestational hypertensive disease, because this could create much unnecessary anxiety in a large number of women who in fact will never develop ischemic heart disease," Wikstsrom and colleagues write in BJOG: an International Journal of Obstetrics and Gynaecology.

BJOG: an International Journal of Obstetrics and Gynecology, November 2005.