Hypertensive pregnancy disorders and subsequent cardiovascular morbidity and type 2 diabetes mellitus in the mother

Jacob A Lykke; Jens Langhoff-Roos; Baha M Sibai; Edmund F Funai; Elizabeth W Triche; Michael J Paidas

doi:10.1161/HYPERTENSIONAHA.109.130765

Hypertensive pregnancy disorders and subsequent cardiovascular morbidity and type 2 diabetes mellitus in the mother

Jacob A Lykke, Jens Langhoff-Roos, Baha M Sibai, Edmund F Funai, Elizabeth W Triche, Michael J Paidas

Ph.d.-studienævnet for Medicin

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

563 Citationer (Scopus)

Abstract

Udgivelsesdato: 2009-Jun

Originalsprog	Engelsk
Tidsskrift	Hypertension
Vol/bind	53
Udgave nummer	6
Sider (fra-til)	944-51
Antal sider	7
ISSN	0194-911X
DOI	https://doi.org/10.1161/HYPERTENSIONAHA.109.130765
Status	Udgivet - 2009

Bibliografisk note

Keywords: Adult; Cardiovascular Diseases; Case-Control Studies; Cohort Studies; Denmark; Diabetes Mellitus, Type 2; Female; Humans; Hypertension, Pregnancy-Induced; Incidence; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Pregnancy Rate; Pregnancy, High-Risk; Premature Birth; Probability; Proportional Hazards Models; Registries; Severity of Illness Index; Young Adult

Adgang til dokumentet

10.1161/HYPERTENSIONAHA.109.130765

Citationsformater

@article{43ff20d067fb11df928f000ea68e967b,

title = "Hypertensive pregnancy disorders and subsequent cardiovascular morbidity and type 2 diabetes mellitus in the mother",

abstract = "Minimal data exist concerning the relationship between hypertensive pregnancy disorders and various subsequent cardiovascular events and the effect of type 2 diabetes mellitus on these. In a registry-based cohort study, we identified women delivering in Denmark from 1978 to 2007 with a first singleton (n=782 287) and 2 first consecutive singleton deliveries (n=536 419). The exposures were gestational hypertension and mild and severe preeclampsia. We adjusted for preterm delivery, small for gestational age, placental abruption, and stillbirth and, in a second model, we also adjusted for the development of type 2 diabetes mellitus. The end points were subsequent hypertension, ischemic heart disease, congestive heart failure, thromboembolic event, stroke, and type 2 diabetes mellitus. The risk of subsequent hypertension was increased 5.31-fold (range: 4.90 to 5.75) after gestational hypertension, 3.61-fold (range: 3.43 to 3.80) after mild preeclampsia, and 6.07-fold (range: 5.45 to 6.77) after severe preeclampsia. The risk of subsequent type 2 diabetes mellitus was increased 3.12-fold (range: 2.63 to 3.70) after gestational hypertension and 3.68-fold (range: 3.04 to 4.46) after severe preeclampsia. Women having 2 pregnancies both complicated by preeclampsia had a 6.00-fold (range: 5.40 to 6.67) increased risk of subsequent hypertension compared with 2.70-fold (range: 2.51 to 2.90) for women having preeclampsia in their first pregnancy only and 4.34-fold (range: 3.98 to 4.74) for women having preeclampsia in their second pregnancy only. The risk of subsequent thromboembolism was 1.03-fold (range: 0.73 to 1.45), 1.53-fold (range: 1.32 to 1.77), and 1.91-fold (range: 1.35 to 2.70) increased after gestational hypertension and mild and severe preeclampsia, respectively. Thus, hypertensive pregnancy disorders are strongly associated with subsequent type 2 diabetes mellitus and hypertension, the latter independent of subsequent type 2 diabetes mellitus. The severity, parity, and recurrence of these hypertensive pregnancy disorders increase the risk of subsequent cardiovascular events.",

author = "Lykke, {Jacob A} and Jens Langhoff-Roos and Sibai, {Baha M} and Funai, {Edmund F} and Triche, {Elizabeth W} and Paidas, {Michael J}",

note = "Keywords: Adult; Cardiovascular Diseases; Case-Control Studies; Cohort Studies; Denmark; Diabetes Mellitus, Type 2; Female; Humans; Hypertension, Pregnancy-Induced; Incidence; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Pregnancy Rate; Pregnancy, High-Risk; Premature Birth; Probability; Proportional Hazards Models; Registries; Severity of Illness Index; Young Adult",

year = "2009",

doi = "10.1161/HYPERTENSIONAHA.109.130765",

language = "English",

volume = "53",

pages = "944--51",

journal = "Hypertension",

issn = "0194-911X",

publisher = "Lippincott Williams & Wilkins",

number = "6",

}

TY - JOUR

T1 - Hypertensive pregnancy disorders and subsequent cardiovascular morbidity and type 2 diabetes mellitus in the mother

AU - Lykke, Jacob A

AU - Langhoff-Roos, Jens

AU - Sibai, Baha M

AU - Funai, Edmund F

AU - Triche, Elizabeth W

AU - Paidas, Michael J

N1 - Keywords: Adult; Cardiovascular Diseases; Case-Control Studies; Cohort Studies; Denmark; Diabetes Mellitus, Type 2; Female; Humans; Hypertension, Pregnancy-Induced; Incidence; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Pregnancy Rate; Pregnancy, High-Risk; Premature Birth; Probability; Proportional Hazards Models; Registries; Severity of Illness Index; Young Adult

PY - 2009

Y1 - 2009

N2 - Minimal data exist concerning the relationship between hypertensive pregnancy disorders and various subsequent cardiovascular events and the effect of type 2 diabetes mellitus on these. In a registry-based cohort study, we identified women delivering in Denmark from 1978 to 2007 with a first singleton (n=782 287) and 2 first consecutive singleton deliveries (n=536 419). The exposures were gestational hypertension and mild and severe preeclampsia. We adjusted for preterm delivery, small for gestational age, placental abruption, and stillbirth and, in a second model, we also adjusted for the development of type 2 diabetes mellitus. The end points were subsequent hypertension, ischemic heart disease, congestive heart failure, thromboembolic event, stroke, and type 2 diabetes mellitus. The risk of subsequent hypertension was increased 5.31-fold (range: 4.90 to 5.75) after gestational hypertension, 3.61-fold (range: 3.43 to 3.80) after mild preeclampsia, and 6.07-fold (range: 5.45 to 6.77) after severe preeclampsia. The risk of subsequent type 2 diabetes mellitus was increased 3.12-fold (range: 2.63 to 3.70) after gestational hypertension and 3.68-fold (range: 3.04 to 4.46) after severe preeclampsia. Women having 2 pregnancies both complicated by preeclampsia had a 6.00-fold (range: 5.40 to 6.67) increased risk of subsequent hypertension compared with 2.70-fold (range: 2.51 to 2.90) for women having preeclampsia in their first pregnancy only and 4.34-fold (range: 3.98 to 4.74) for women having preeclampsia in their second pregnancy only. The risk of subsequent thromboembolism was 1.03-fold (range: 0.73 to 1.45), 1.53-fold (range: 1.32 to 1.77), and 1.91-fold (range: 1.35 to 2.70) increased after gestational hypertension and mild and severe preeclampsia, respectively. Thus, hypertensive pregnancy disorders are strongly associated with subsequent type 2 diabetes mellitus and hypertension, the latter independent of subsequent type 2 diabetes mellitus. The severity, parity, and recurrence of these hypertensive pregnancy disorders increase the risk of subsequent cardiovascular events.

AB - Minimal data exist concerning the relationship between hypertensive pregnancy disorders and various subsequent cardiovascular events and the effect of type 2 diabetes mellitus on these. In a registry-based cohort study, we identified women delivering in Denmark from 1978 to 2007 with a first singleton (n=782 287) and 2 first consecutive singleton deliveries (n=536 419). The exposures were gestational hypertension and mild and severe preeclampsia. We adjusted for preterm delivery, small for gestational age, placental abruption, and stillbirth and, in a second model, we also adjusted for the development of type 2 diabetes mellitus. The end points were subsequent hypertension, ischemic heart disease, congestive heart failure, thromboembolic event, stroke, and type 2 diabetes mellitus. The risk of subsequent hypertension was increased 5.31-fold (range: 4.90 to 5.75) after gestational hypertension, 3.61-fold (range: 3.43 to 3.80) after mild preeclampsia, and 6.07-fold (range: 5.45 to 6.77) after severe preeclampsia. The risk of subsequent type 2 diabetes mellitus was increased 3.12-fold (range: 2.63 to 3.70) after gestational hypertension and 3.68-fold (range: 3.04 to 4.46) after severe preeclampsia. Women having 2 pregnancies both complicated by preeclampsia had a 6.00-fold (range: 5.40 to 6.67) increased risk of subsequent hypertension compared with 2.70-fold (range: 2.51 to 2.90) for women having preeclampsia in their first pregnancy only and 4.34-fold (range: 3.98 to 4.74) for women having preeclampsia in their second pregnancy only. The risk of subsequent thromboembolism was 1.03-fold (range: 0.73 to 1.45), 1.53-fold (range: 1.32 to 1.77), and 1.91-fold (range: 1.35 to 2.70) increased after gestational hypertension and mild and severe preeclampsia, respectively. Thus, hypertensive pregnancy disorders are strongly associated with subsequent type 2 diabetes mellitus and hypertension, the latter independent of subsequent type 2 diabetes mellitus. The severity, parity, and recurrence of these hypertensive pregnancy disorders increase the risk of subsequent cardiovascular events.

U2 - 10.1161/HYPERTENSIONAHA.109.130765

DO - 10.1161/HYPERTENSIONAHA.109.130765

M3 - Journal article

C2 - 19433776

VL - 53

SP - 944

EP - 951

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 6

ER -