Question

Please explain in laymans term :(

Background and aim: Hypertensive pregnancy disorders are associated with subsequent cardiovascular disease
(CVD), but the extent to which this association is explained by shared risk factors is unknown.Weaimed to evaluatewhether
hypertensive pregnancy disorder in first pregnancy is associated with increased subsequent risk of
maternal CVD after adjustment for established CVD risk factors measured after pregnancy.
Methods and results: A total of 20,075 women with a first delivery registered in the Medical Birth Registry of
Norway (1980–2003) participated in Cohort of Norway (CONOR) health surveys a mean (standard deviation)
of 10.7 (5.5) years after delivery. They were then followed (median 11.4 years) for an incident fatal or nonfatal
CVD event through linkage to the Cardiovascular Disease inNorway (CVDNOR) database and theNorwegian
Cause of Death Registry. Hypertensive pregnancy disorders were associated with an increased risk of CVD [Hazard
ratio (HR) 2.3; 95% confidence interval (CI) 1.9–2.8], which remained significant after adjustment for
established CVD risk factors including body mass index, smoking, hypertension, diabetes, serum glucose and
lipid levels (HR 1.5; 95% CI 1.2–1.8). The population attributable fraction of CVD due to hypertensive pregnancy
disorder was 4.3% (95% CI 1.9–6.6) after multivariable adjustment.
Conclusion: The association between hypertensive pregnancy disorders and CVD riskwas mediated in part by related
CVD risk factors measured 10 years following delivery. These results underline the importance of postpregnancy
follow-up of women with hypertensive pregnancy disorders focusing on modifiable, lifestyle related
risk factors to prevent future CVD.

Answer 1

Ans) Hypertensive pregnancy disorders increase the risk of cardiovascular disease.

• Known cardiovascular risk factors do not fully explain the elevated risk of heart disease after hypertension in pregnancy.

• Post-pregnancy follow-up after a pregnancy complicated by hypertension is important.

• Preeclampsia and gestational hypertension were associated with subsequent risk of
maternal CVD, and the risk was further elevated with the additional presence of SGA
and/or preterm delivery. Parity-specific analyses indicated the highest risk of CVD
after recurrent hypertensive pregnancy disorder. After accounting for established CVD
risk factors measured in CONOR subsequent to the first delivery, an independent risk
of CVD was still observed. These results underline the importance of post-pregnancy
follow-up of women with hypertensive pregnancy disorders.