Hypertensive Disorders in Pregnancy Associated With Lasting Effects on the Heart

Hypertensive Disorders in Pregnancy
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A study led by Cedars-Sinai investigators found that women who experience a hypertensive disorder during their pregnancy are more likely to have lasting changes in the structure and function of their hearts.

LOS ANGELES (Dec. 26, 2023) — New research from the Smidt Heart Institute at Cedars-Sinai found that women who developed signs of elevated blood pressure during pregnancy were more likely to have residual evidence of abnormal heart structure and function up to a decade after the pregnancy.

“This study helps to clarify that, for some women, pregnancy is not just a ‘stress test’ that unmasks underlying cardiovascular risks,” said Susan Cheng, MD, MPH, the Erika J. Glazer Chair in Women’s Cardiovascular Health and Population Science, director of the Institute for Research on Healthy Aging in the Department of Cardiology in the Smidt Heart Institute, and senior author of the study. “This risk may also affect the heart years after pregnancy.”

The study, recently published in the peer-reviewed journal Hypertension, looked at more than 5,000 Hispanic/Latina women with at least one prior pregnancy and identified those who had hypertensive disorders of pregnancy, such as gestational hypertension, preeclampsia or eclampsia.

“This study confirms the results of others and demonstrates that women who experience a hypertensive disorder during their pregnancy are more likely to have lasting changes in the structure and function of their hearts than women who have normal blood pressure during their pregnancy,” said Natalie Bello, MD, MPH, director of Hypertension Research in the Smidt Heart Institute and co-author of the study. “Further, this work shows that only a portion of the abnormalities in the heart are explained by the woman’s current blood pressure.”

After accounting for other cardiovascular risk factors that might otherwise lead to early signs of heart disease, researchers found that the approximately 14% of study participants who had developed hypertensive disorders during pregnancy had several persistent heart-related issues found on cardiac imaging. These included greater heart-wall thickness, more frequent abnormal left-ventricle geometry and lower ejection fraction when compared to women who also had a prior pregnancy but without any related hypertensive disorder.

Although they make up a large and growing population of the United States, historically, Hispanic/Latina women have been underrepresented in medical studies. Using data from the Hispanic Community Health Study/Study of Latinos—a multicenter community-based study—investigators were able to engage this diverse population in their research. However, study authors say that given the underlying diversity of Hispanic/Latinx people, the findings of this study are not likely to be specific to any particular ethnicity, race or national origin.

“Cedars-Sinai has long invested in women’s heart health research, and this newest, critical study deepens our understanding of who is most at risk for hypertensive disorders in pregnancy,” said Christine M. Albert, MD, MPH, who is chair of the Department of Cardiology in the Smidt Heart Institute and holds the Lee and Harold Kapelovitz Distinguished Chair in Cardiology and was not involved in this study.

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