Hypertensive Disorders in Pregnancy Linked to Early Coronary Artery Disease in Women, reveals research

 A new study published in the Journal of the American College of Cardiology illuminate the critical relationship between hypertensive disorders of pregnancy (HDP) and the risk of developing early coronary artery disease (CAD) in women. Data from Olmsted County, Minnesota were analyzed, where the research revealed patterns in women with a history of HDP by emphasizing the importance of early diagnosis and customized treatments.

The study followed a total of 506 women diagnosed with incident CAD who underwent coronary angiography between 2002 and 2016. It found that women with HDP were significantly younger at the time of their CAD diagnosis when compared to their counterparts with normotensive pregnancies. The median age at diagnosis for HDP-affected women was 64.8 years, nearly 7 years younger than the median age of 71.8 years for women with normal pregnancies.

Further, this study identified a strong link between HDP and acute coronary syndromes (ACS). Women with a history of HDP were over twice as likely to express higher SYNTAX scores, a measure of the complexity and severity of coronary artery disease. This association highlights the elevated risk of more advanced and intricate coronary blockages in these women.

Another critical finding was the increased risk of myocardial infarction with nonobstructive coronary arteries (MINOCA) among women with HDP. This condition, characterized by acute myocardial infarction without significant coronary artery obstruction, was over twice as common in the HDP group. The results underline the unique mechanisms of CAD in women with a history of pregnancy complications.

This study illuminate the importance of viewing HDP as a crucial early risk factor for CAD. While traditional risk factors such as high cholesterol and diabetes remain vital considerations, the study advocates for integrating HDP history into cardiovascular risk assessments for women. Early interventions and a focus on nonobstructive coronary disease could improve outcomes for this high-risk group.

HDP, including preeclampsia and gestational hypertension, is increasingly recognized as a precursor to cardiovascular disease later in life. This research adds new evidence by demonstrating its role in accelerating CAD onset and influencing the type of coronary artery disease, including more severe or nonobstructive forms. Overall, the findings point to an urgent need for improved monitoring of women with HDP and further research to understand the underlying mechanisms linking pregnancy-related hypertension to future heart disease.

Source:

Vaughan, L. E., Kanaji, Y., Suvakov, S., Parashuram, S., Butler Tobah, Y. S., Chamberlain, A. M., Bielinski, S. J., Milic, N., Gulati, R., Nath, K. A., Lerman, A., & Garovic, V. D. (2024). Hypertensive Disorders of Pregnancy Increase the Risk for Myocardial Infarction. In Journal of the American College of Cardiology. Elsevier BV. https://doi.org/10.1016/j.jacc.2024.06.049