San-Nung Chen1, Chin-Chang Cheng2, Kuan-Hao Tsui3, Pei-Ling Tang4, Chyi-Uei Chern1, Wei-Chun Huang2, Li-Te Lin5. 1. Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. 2. Critical Care Center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Physical Therapy, Fooyin University, Kaohsiung City, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. 3. Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Pharmacy and Master Program, College of Pharmacy and Health Care, Tajen University, Pingtung County, Taiwan. 4. Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Nursing, Meiho University, Pingtung, Taiwan; College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan. 5. Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan. Electronic address: litelin1982@gmail.com.
Abstract
OBJECTIVE: To assess whether hypertensive disorders of pregnancy (HDP) increased the risk of subsequent heart failure (HF) and identify possible risk factors. STUDY DESIGN: A nationwide population-based retrospective cohort study. MAIN OUTCOME MEASURES: Incidence of heart failure. RESULTS: Among the 23.3 million individuals registered in the National Health Insurance Research Database in Taiwan, 29,186 patients with HDP and 116,744 matched controls were identified. The overall incidence of HF was greater in the HDP group than it was in the control group (9.83 vs. 1.67 per 10,000 person-years), with a significant incidence rate ratio (IRR = 5.88, 95% confidence interval [CI] 5.84-5.92, p < 0.0001). When stratified by age, parity, gestational age, gestational number, and follow-up years, the IRR for subsequent HF remained significantly higher in the HDP group in all stratifications. Additionally, the Kaplan-Meier analysis indicated that the cumulative incidence rate of HF was higher in the HDP group than it was in the control group. The Cox proportional-hazard model analysis showed that in addition to HDP, single parity, preterm and hypertension were independent risk factors for developing HF. Moreover, HF was more likely to develop within 5 years post-partum. Among patients with a history of HDP, the Cox proportional-hazard model showed that severe forms of HDP and increased HDP occurrences were independently associated with the subsequent development of HF. CONCLUSIONS: Patients who have experienced HDP presented an increased risk for developing HF later in life. Moreover, among individuals with a history of HDP, those with severe forms of HDP or recurrent HDP displayed an increased subsequent risk of HF.
OBJECTIVE: To assess whether hypertensive disorders of pregnancy (HDP) increased the risk of subsequent heart failure (HF) and identify possible risk factors. STUDY DESIGN: A nationwide population-based retrospective cohort study. MAIN OUTCOME MEASURES: Incidence of heart failure. RESULTS: Among the 23.3 million individuals registered in the National Health Insurance Research Database in Taiwan, 29,186 patients with HDP and 116,744 matched controls were identified. The overall incidence of HF was greater in the HDP group than it was in the control group (9.83 vs. 1.67 per 10,000 person-years), with a significant incidence rate ratio (IRR = 5.88, 95% confidence interval [CI] 5.84-5.92, p < 0.0001). When stratified by age, parity, gestational age, gestational number, and follow-up years, the IRR for subsequent HF remained significantly higher in the HDP group in all stratifications. Additionally, the Kaplan-Meier analysis indicated that the cumulative incidence rate of HF was higher in the HDP group than it was in the control group. The Cox proportional-hazard model analysis showed that in addition to HDP, single parity, preterm and hypertension were independent risk factors for developing HF. Moreover, HF was more likely to develop within 5 years post-partum. Among patients with a history of HDP, the Cox proportional-hazard model showed that severe forms of HDP and increased HDP occurrences were independently associated with the subsequent development of HF. CONCLUSIONS:Patients who have experienced HDP presented an increased risk for developing HF later in life. Moreover, among individuals with a history of HDP, those with severe forms of HDP or recurrent HDP displayed an increased subsequent risk of HF.
Authors: Dominique Williams; Molly J Stout; Joshua I Rosenbloom; Margaret A Olsen; Karen E Joynt Maddox; Elena Deych; Victor G Davila-Roman; Kathryn J Lindley Journal: J Am Coll Cardiol Date: 2021-12-07 Impact factor: 24.094
Authors: Angela M Malek; Dulaney A Wilson; Tanya N Turan; Julio Mateus; Daniel T Lackland; Kelly J Hunt Journal: J Am Heart Assoc Date: 2021-08-25 Impact factor: 6.106
Authors: Anca Maria Panaitescu; Mihaela Roxana Popescu; Anca Marina Ciobanu; Nicolae Gica; Brindusa Ana Cimpoca-Raptis Journal: Medicina (Kaunas) Date: 2021-12-01 Impact factor: 2.430