Hypertension during pregnancy is associated with coronary artery calcium independent of renal function

J Womens Health (Larchmt). 2009 Oct;18(10):1709-16. doi: 10.1089/jwh.2008.1285.

Abstract

Background: Hypertension during pregnancy (HDP) increases the risk of future coronary heart disease (CHD), but it is unknown whether this association is mediated by renal injury. Reduced renal function is both a complication of HDP and a risk factor for CHD.

Methods: Logistic regression models were fit to examine the association between a history of HDP and the presence and extent of coronary artery calcification (CAC), a measure of subclinical coronary artery atherosclerosis, in 498 women from the Epidemiology of Coronary Artery Calcification Study (mean age 63.3 +/- 9.3 years).

Results: Fifty-two (10.4%) women reported a history of HDP. After adjusting for age at time of study participation, HDP was associated with increased serum creatinine later in life (p = 0.014). HDP was positively associated with the presence of CAC after adjusting for age at time of study participation (OR = 2.7, 95% CI 1.4-5.4). This association was slightly attenuated with adjustment for body size and blood pressure (OR = 2.4, 95% CI 1.2-4.9) but was not further attenuated with adjustment for serum creatinine and urinary albumin/creatinine ratio (OR = 2.6, 95% CI 1.3-5.3). Results were similar for CAC extent.

Conclusions: HDP may increase a woman's risk of future CHD beyond traditional risk factors and renal function. Women with a history of HDP should be monitored for potential increased risk of CHD as they age.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Calcinosis / diagnosis
  • Calcinosis / epidemiology*
  • Causality
  • Comorbidity
  • Confidence Intervals
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / epidemiology*
  • Coronary Vessels / pathology
  • Creatinine / blood
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced / epidemiology*
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Odds Ratio
  • Pregnancy
  • Risk Factors
  • Women's Health*

Substances

  • Creatinine