Cardiovascular Health in Pregnancy and Beyond

We examined the association between hypertensive disorders of pregnancy, such as gestational hypertension and preeclampsia, and their association with cardiovascular risk factors in and after pregnancy. We showed that women with a hypertensive disorder of pregnancy often have cardiovascular risk factors, such as hypertension and a disadvantageous lipid profile, within the first nine years after pregnancy. From the age of 45 years onwards they also have a higher risk of coronary artery calcification and plaque formation compared to women without a history of preeclampsia. Cardiovascular risk factors can be assembled in one score which is the cardiovascular health score. A higher, and thus healthier, cardiovascular health score is associated with a lower risk of future cardiovascular disease. We showed that a lower cardiovascular health score in early pregnancy is associated with a lower cardiovascular health score after pregnancy and with a greater carotid intima-media thickness. A measure of subclinical vascular disease. These results were strongest in women with a previous hypertensive disorder of pregnancy. Women with a previous hypertensive disorder of pregnancy have a higher risk of having cardiovascular risk factors after pregnancy than women with a previous normotensive pregnancy. Therefore, they should be offered cardiovascular follow-up from an early age onwards. The cardiovascular health score in early pregnancy might be a good start to improve cardiovascular risk factors in these young women.

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