Pre-eclampsia and cardiovascular risk: a long-term nationwide cohort study on over 120 000 Finnish women
Objectives To investigate the impact of pre-eclampsia on the future cardiovascular risk in Finnish womenDesign A registry-based nationwide controlled cohort study.Setting Women hospitalised for pre-eclampsia in 1969–1993 and control women with a history of normotensive pregnancies followed from the...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/12/e064736.full |
| _version_ | 1827909716879081472 |
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| author | Mika Gissler Hanna Savolainen-Peltonen Olavi Ylikorkala Johanna Joensuu Minttu Venetkoski Tomi Sakari Mikkola |
| author_facet | Mika Gissler Hanna Savolainen-Peltonen Olavi Ylikorkala Johanna Joensuu Minttu Venetkoski Tomi Sakari Mikkola |
| author_sort | Mika Gissler |
| collection | DOAJ |
| description | Objectives To investigate the impact of pre-eclampsia on the future cardiovascular risk in Finnish womenDesign A registry-based nationwide controlled cohort study.Setting Women hospitalised for pre-eclampsia in 1969–1993 and control women with a history of normotensive pregnancies followed from the pre-eclampsia diagnosis until 2019 for cardiovascular outcomes.Participants 31 688 women with and 91 726 control women without a history of pre-eclampsia.Primary outcome measures Incidences of and deaths from ischaemic heart disease (IHD), myocardial infarction (MI) and stroke.Results In total, 25 813 (81.5%) women had pre-eclampsia without severe features, 4867 (15.4%) had pre-eclampsia with severe features and 1006 (3.2%) women developed eclampsia. Women with a history of pre-eclampsia showed elevated risks for IHD (HR 1.52, 95% CI 1.44 to 1.59), MI (HR 1.66, 95% CI 1.52 to 1.81) and stroke (HR 1.40, 95% CI 1.32 to 1.48). The risks for death from IHD (HR 1.50, 95% CI 1.28 to 1.75), MI (1.63, 95% CI 1.30 to 2.05) and stroke (1.44, 95% CI 1.03 to 2.01) were also elevated. Pre-eclampsia with severe features or eclampsia was accompanied with 15% higher IHD risk, 19% higher MI risk and 26% higher stroke risk than pre-eclampsia without severe features. The highest risk elevations of 30% for IHD, 32% for MI and 30% for stroke were observed in women with recurrent pre-eclampsia (n=4180).Conclusion Pre-eclampsia-related significant elevations in CVD risks of Finnish women with inherently high risk for these diseases were of the same magnitude as reported previously from other countries. Thus, women with a history of pre-eclampsia should be screened and treated early for modifiable cardiovascular risk factors. |
| first_indexed | 2024-03-13T01:42:44Z |
| format | Article |
| id | doaj.art-6780ae1db59a4787a8aabb43b322b680 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-13T01:42:44Z |
| publishDate | 2022-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-6780ae1db59a4787a8aabb43b322b6802023-07-03T12:30:06ZengBMJ Publishing GroupBMJ Open2044-60552022-12-01121210.1136/bmjopen-2022-064736Pre-eclampsia and cardiovascular risk: a long-term nationwide cohort study on over 120 000 Finnish womenMika Gissler0Hanna Savolainen-Peltonen1Olavi Ylikorkala2Johanna Joensuu3Minttu Venetkoski4Tomi Sakari Mikkola5Academic Primary Health Care Centre, Stockholm, Region Stockholm, SwedenDepartment of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, FinlandDepartment of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, FinlandFaculty of Management and Business, Tampere University, Tampere, FinlandDepartment of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, FinlandDepartment of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, FinlandObjectives To investigate the impact of pre-eclampsia on the future cardiovascular risk in Finnish womenDesign A registry-based nationwide controlled cohort study.Setting Women hospitalised for pre-eclampsia in 1969–1993 and control women with a history of normotensive pregnancies followed from the pre-eclampsia diagnosis until 2019 for cardiovascular outcomes.Participants 31 688 women with and 91 726 control women without a history of pre-eclampsia.Primary outcome measures Incidences of and deaths from ischaemic heart disease (IHD), myocardial infarction (MI) and stroke.Results In total, 25 813 (81.5%) women had pre-eclampsia without severe features, 4867 (15.4%) had pre-eclampsia with severe features and 1006 (3.2%) women developed eclampsia. Women with a history of pre-eclampsia showed elevated risks for IHD (HR 1.52, 95% CI 1.44 to 1.59), MI (HR 1.66, 95% CI 1.52 to 1.81) and stroke (HR 1.40, 95% CI 1.32 to 1.48). The risks for death from IHD (HR 1.50, 95% CI 1.28 to 1.75), MI (1.63, 95% CI 1.30 to 2.05) and stroke (1.44, 95% CI 1.03 to 2.01) were also elevated. Pre-eclampsia with severe features or eclampsia was accompanied with 15% higher IHD risk, 19% higher MI risk and 26% higher stroke risk than pre-eclampsia without severe features. The highest risk elevations of 30% for IHD, 32% for MI and 30% for stroke were observed in women with recurrent pre-eclampsia (n=4180).Conclusion Pre-eclampsia-related significant elevations in CVD risks of Finnish women with inherently high risk for these diseases were of the same magnitude as reported previously from other countries. Thus, women with a history of pre-eclampsia should be screened and treated early for modifiable cardiovascular risk factors.https://bmjopen.bmj.com/content/12/12/e064736.full |
| spellingShingle | Mika Gissler Hanna Savolainen-Peltonen Olavi Ylikorkala Johanna Joensuu Minttu Venetkoski Tomi Sakari Mikkola Pre-eclampsia and cardiovascular risk: a long-term nationwide cohort study on over 120 000 Finnish women BMJ Open |
| title | Pre-eclampsia and cardiovascular risk: a long-term nationwide cohort study on over 120 000 Finnish women |
| title_full | Pre-eclampsia and cardiovascular risk: a long-term nationwide cohort study on over 120 000 Finnish women |
| title_fullStr | Pre-eclampsia and cardiovascular risk: a long-term nationwide cohort study on over 120 000 Finnish women |
| title_full_unstemmed | Pre-eclampsia and cardiovascular risk: a long-term nationwide cohort study on over 120 000 Finnish women |
| title_short | Pre-eclampsia and cardiovascular risk: a long-term nationwide cohort study on over 120 000 Finnish women |
| title_sort | pre eclampsia and cardiovascular risk a long term nationwide cohort study on over 120 000 finnish women |
| url | https://bmjopen.bmj.com/content/12/12/e064736.full |
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