A groundbreaking study has revealed that women with a history of hypertensive disorders during pregnancy face a significantly higher risk of developing coronary artery disease (CAD) and myocardial infarction (MI) later in life.
The population-based study included 506 women from Olmsted County, Minnesota, who underwent coronary angiography for incident CAD. Women with a history of hypertensive disorders of pregnancy (HDP), such as preeclampsia, were not only younger at the time of CAD diagnosis (median age 64.8 years vs. 71.8 years for normotensive women) but also more likely to suffer from acute coronary syndrome (ACS). Moreover, these women exhibited higher SYNTAX scores, reflecting greater complexity of CAD, and were at increased risk of myocardial infarction with nonobstructive coronary arteries (MINOCA).
Researchers identified a strong association between HDP and ACS, with HDP doubling the odds of severe CAD and MINOCA compared to normotensive pregnancies. These findings suggest that HDP serves as a distinct risk factor for early coronary disease, independent of traditional cardiovascular risks.
The study calls for heightened vigilance in women with a history of HDP, emphasizing the importance of early detection and management of both obstructive and nonobstructive coronary disease. This proactive approach could mitigate the heightened cardiovascular risk associated with hypertensive pregnancies, potentially saving lives.
This research highlights the long-term impact of pregnancy-related complications, urging healthcare providers to incorporate a history of HDP into cardiovascular risk assessments for women.
Reference
Vaughan LE et al. Hypertensive disorders of pregnancy increase the risk for myocardial infarction: a population-based study. JACC. 2024;84(33):2264-74.
