Patterns of Gestational Hypertension or Preeclampsia Across 2 Pregnancies in Relationship to Chronic Hypertension Development: A Retrospective Cohort Study

Experiencing preeclampsia or gestational hypertension (high blood pressure diagnosed for the first time in pregnancy after 20 weeks gestation) has been linked to developing high blood pressure later in life. For patients who have more than one pregnancy, these conditions can occur more than once. However, it is not well known how the recurrence of these conditions affects an individual's risk for developing high blood pressure later in life.

In this study, researchers used national data from Canada that included patients with two deliveries to answer the question: How does the risk for developing high blood pressure later in life change for individuals who never experienced preeclampsia/gestational hypertension compared to those who only experienced it in the first pregnancy, those who only experienced it in the second pregnancy, and those who experienced preeclampsia or gestational hypertension in both pregnancies?

Over 400,000 patients were included in the analysis, and among those, nearly 28,000 had developed high blood pressure so far. Compared to those who never experienced preeclampsia or gestational hypertension, patients who had experienced preeclampsia at least 1 or more times had a stepwise (or in other words, the more times you have preeclampsia, the stronger the risk) increased risk of developing high blood pressure.

Patients with preeclampsia or gestational hypertension in their first pregnancy only had about a 2.7 times higher risk of developing chronic hypertension. Patients with preeclampsia or gestational hypertension in only their second pregnancy had about a 4.9 times higher risk of developing long-term chronic hypertension.

And for patients who had preeclampsia or gestational hypertension in both their first and second pregnancies, their risk of developing long-term chronic hypertension was 7.3 times higher than a woman with no history of hypertensive disorders of pregnancy.

Take home: Having preeclampsia or gestational hypertension in more than one pregnancy may increase your future risk of developing high blood pressure after pregnancy and long-term chronic hypertension. Patients who have experienced preeclampsia more than once should be extra vigilant in attending regular well-woman visits and ensuring close blood pressure monitoring and management. It’s important to note that this study is based on national Canadian data, so similar studies would need to be done in US-based populations.

Link: https://pubmed.ncbi.nlm.nih.gov/38904245/

Citation: Mussa J, Rahme E, Dahhou M, Nakhla M, Dasgupta K. Patterns of Gestational Hypertension or Preeclampsia Across 2 Pregnancies in Relationship to Chronic Hypertension Development: A Retrospective Cohort Study. J Am Heart Assoc. 2024 Jul 2;13(13):e034777. doi: 10.1161/JAHA.124.034777. Epub 2024 Jun 21. PMID: 38904245; PMCID: PMC11255691.

About Research Roundup

Each quarter, our team of science writers reviews the most current research studies related to hypertensive disorders of pregnancy and summarizes those studies of greatest interest and potential impact to our community, including research studies related to risk assessment, diagnosis, prevention, and treatment. Special thanks to our volunteer research team, including Dr. Sig-Linda Jacobson, Dr. Jennifer Mitchell, and Amanda Yang, who under the leadership of Dr. Elizabeth Sutton, make Research Roundup possible, and to our Patient Advisory Council, who reviews these materials from the patient perspective.