Yi-Xin Wang1, Mariel Arvizu1, Janet W Rich-Edwards2, Liang Wang3, Bernard Rosner4, Jennifer J Stuart2, Kathryn M Rexrode5, Jorge E Chavarro6. 1. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. 2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. 3. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, USA. 4. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. 5. Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. 6. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: jchavarr@hsph.harvard.edu.
Abstract
BACKGROUND: Hypertensive disorders of pregnancy (HDPs) are leading causes of maternal and perinatal morbidity and mortality. However, it is uncertain whether HDPs are associated with long-term risk of premature mortality (before age 70 years). OBJECTIVES: The objective of this study was to evaluate whether HDPs were associated with premature mortality. METHODS: Between 1989 and 2017, the authors followed 88,395 parous female nurses participating in the Nurses' Health Study II. The study focused on gestational hypertension and pre-eclampsia within the term HDPs. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between HDPs and premature mortality were estimated by using Cox proportional hazards models, with adjustment for relevant confounders. RESULTS: The authors documented that 2,387 women died before age 70 years, including 1,141 cancer deaths and 212 CVD deaths. The occurrence of HDPs, either gestational hypertension or pre-eclampsia, was associated with an HR of 1.31 (95% CI: 1.18 to 1.46) for premature death during follow-up. When specific causes of death were examined, these relations were strongest for CVD-related mortality (HR: 2.26; 95% CI: 1.67 to 3.07). The association between HDPs and all-cause premature death persisted, regardless of the subsequent development of chronic hypertension (HR: 1.20 [95% CI: 1.02 to 1.40] for HDPs only and HR: 2.02 [95% CI: 1.75 to 2.33] for both HDPs and subsequent chronic hypertension). CONCLUSIONS: An occurrence of HDPs, either gestational hypertension or pre-eclampsia, was associated with an increased risk of premature mortality, particularly CVD mortality, even in the absence of chronic hypertension.
BACKGROUND: Hypertensive disorders of pregnancy (HDPs) are leading causes of maternal and perinatal morbidity and mortality. However, it is uncertain whether HDPs are associated with long-term risk of premature mortality (before age 70 years). OBJECTIVES: The objective of this study was to evaluate whether HDPs were associated with premature mortality. METHODS: Between 1989 and 2017, the authors followed 88,395 parous female nurses participating in the Nurses' Health Study II. The study focused on gestational hypertension and pre-eclampsia within the term HDPs. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between HDPs and premature mortality were estimated by using Cox proportional hazards models, with adjustment for relevant confounders. RESULTS: The authors documented that 2,387 women died before age 70 years, including 1,141 cancer deaths and 212 CVD deaths. The occurrence of HDPs, either gestational hypertension or pre-eclampsia, was associated with an HR of 1.31 (95% CI: 1.18 to 1.46) for premature death during follow-up. When specific causes of death were examined, these relations were strongest for CVD-related mortality (HR: 2.26; 95% CI: 1.67 to 3.07). The association between HDPs and all-cause premature death persisted, regardless of the subsequent development of chronic hypertension (HR: 1.20 [95% CI: 1.02 to 1.40] for HDPs only and HR: 2.02 [95% CI: 1.75 to 2.33] for both HDPs and subsequent chronic hypertension). CONCLUSIONS: An occurrence of HDPs, either gestational hypertension or pre-eclampsia, was associated with an increased risk of premature mortality, particularly CVD mortality, even in the absence of chronic hypertension.
Authors: Mark A Brown; Laura A Magee; Louise C Kenny; S Ananth Karumanchi; Fergus P McCarthy; Shigeru Saito; David R Hall; Charlotte E Warren; Gloria Adoyi; Salisu Ishaku Journal: Pregnancy Hypertens Date: 2018-05-24 Impact factor: 2.899
Authors: Changzheng Yuan; Donna Spiegelman; Eric B Rimm; Bernard A Rosner; Meir J Stampfer; Junaidah B Barnett; Jorge E Chavarro; Jennifer C Rood; Lisa J Harnack; Laura K Sampson; Walter C Willett Journal: Am J Epidemiol Date: 2018-05-01 Impact factor: 4.897
Authors: Brenda J Wilson; M Stuart Watson; Gordon J Prescott; Sarah Sunderland; Doris M Campbell; Philip Hannaford; W Cairns S Smith Journal: BMJ Date: 2003-04-19
Authors: Jennifer J Stuart; Lauren J Tanz; Stacey A Missmer; Eric B Rimm; Donna Spiegelman; Tamarra M James-Todd; Janet W Rich-Edwards Journal: Ann Intern Med Date: 2018-07-03 Impact factor: 25.391
Authors: Sharon E Maynard; Tiffany A Moore Simas; Matthew J Solitro; Abraham Rajan; Sybil Crawford; Peter Soderland; Bruce A Meyer Journal: Am J Obstet Gynecol Date: 2008-02 Impact factor: 8.661
Authors: Anna C O'Kelly; Erin D Michos; Chrisandra L Shufelt; Jane V Vermunt; Margo B Minissian; Odayme Quesada; Graeme N Smith; Janet W Rich-Edwards; Vesna D Garovic; Samar R El Khoudary; Michael C Honigberg Journal: Circ Res Date: 2022-02-17 Impact factor: 17.367
Authors: Mandy Goldberg; Mary V Díaz-Santana; Katie M O'Brien; Shanshan Zhao; Clarice R Weinberg; Dale P Sandler Journal: Epidemiology Date: 2022-05-30 Impact factor: 4.860
Authors: Priya M Freaney; Katharine Harrington; Rebecca Molsberry; Amanda M Perak; Michael C Wang; William Grobman; Philip Greenland; Norrina B Allen; Simon Capewell; Martin O'Flaherty; Donald M Lloyd-Jones; Sadiya S Khan Journal: J Am Heart Assoc Date: 2022-05-18 Impact factor: 6.106
Authors: Jennifer J Stuart; Lauren J Tanz; Eric B Rimm; Donna Spiegelman; Stacey A Missmer; Kenneth J Mukamal; Kathryn M Rexrode; Janet W Rich-Edwards Journal: J Am Coll Cardiol Date: 2022-05-17 Impact factor: 27.203
Authors: Janet M Catov; Matthew F Muldoon; Robin E Gandley; Judith Brands; Alisse Hauspurg; Carl A Hubel; Marie Tuft; Mandy Schmella; Gong Tang; W Tony Parks Journal: Hypertension Date: 2021-12-09 Impact factor: 9.897