| The long-term health effects of new onset hypertensive (NOH) disorders of pregnancy on women's health are unclear. This study examined the independent association between NOH (defined as preeclampsia or transient hypertension) and subsequent hypertension and all-cause and cardiovascular disease (CVD) mortality. A secondary case-control analysis was conducted for methodological comparison for the mortality NOH relationship.; The study population consisted of 1422 female participants in a prospective study of pregnancy, delivery, and child development between 1960 and 1963 who later participated in a re-examination between 1977 and 1979. Extensive demographic, pregnancy, health, and lifestyle information were collected during on medical conditions and prescription drug use. Current participant vital status was determined through Department of Motor Vehicle and National Death Index searches. The associations between NOH and hypertension and mortality were examined in multivariate regression models with adjustment for confounding variables.; Women with a history of pregnancy complicated by preeclampsia or transient hypertension were found to have a three-fold increased risk of hypertension compared to women with normotensive pregnancies (OR1 = 3.16, 95% CI2: 1.72, 5.83 and OR = 2.96, 95% CI: 2.10, 4.18, respectively). Preeclampsia exposure was associated with a 5.8 mmHg increase in mean arterial pressure (MAP) and transient hypertension exposure was associated with a 4.9 mmHg increase in MAP.; During the average 21 years of follow-up since the 1977–1979 examination, women with pregnancies complicated by transient hypertension had a two-fold increase in all-cause mortality risk and a three-fold increase in CVD mortality risk compared to women with normotensive pregnancies (RR3 = 1.96, 95% CI: 1.37, 2.80 and RR = 3.02, 95% CI: 1.72, 5.31, respectively). Preeclampsia was associated with greater than a four-fold increased risk of CVD mortality (RR = 4.54, 95% CI: 1.81, 11.38) but was not significantly associated with increased risk of total mortality compared to women with normotensive pregnancies (RR = 1.65, 95% CI: 0.8, 3.38). Results from the case-control study yielded results consistent with the full cohort analyses.; The findings of this study suggest a history of NOH during pregnancy might be considered a risk factor or a marker for adverse cardiovascular sequelae later in life.; 1OR = odds ratio; 2CI = confidence interval; 3RR = relative risk. |
