HypertensionCohort study
Hypertensive Disorders of Pregnancy Subtypes and Long-Term Cardiovascular Risk
- nationwide cohort study
- retrospectively analyzed
- National Health Insurance Service database
Authors' conclusion
In this cohort study, all HDP subtypes were associated with modest increases in long-term cardiovascular risk, except superimposed preeclampsia, which was associated with a markedly higher risk. These findings suggest that women with superimposed preeclampsia may benefit from closer postpartum cardiovascular surveillance.
Study context
- Population
- Women with deliveries in South Korea from 2010 to 2018women, 22,876 (4.0%) had HDPs
- Participants
- 570,843 women
- Exposure
- HDPs and their subtypes compared with women without HDPs
- HDPsn = 22,876
- Outcome
- Composite of:
- Cardiovascular events
- Including cardiovascular death
- Heart failure
- Myocardial infarction
- Stroke
- Atrial fibrillation
- Follow-up
- Median 6.5 years (IQR, 4.7-8.7 years)
Main finding
As reported in the abstract
Each group vs women without HDPsAdjusted hazard ratio (95% CI)P value
HDPs
1.62(1.49–1.76)
P < 0.001superimposed preeclampsiahighest risk among subtypes
2.93(2.15–3.99)
P < 0.001- Absolute risk increase, additional cardiovascular events per 1000 person-years
- approximately 2.10
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Distribution of HDP subtypes among those with HDPs · shares of those with HDPs | gestational hypertension 34.8% · preeclampsia/eclampsia 32.4% · unspecified hypertension 17.7% · chronic hypertension 12.3% · superimposed preeclampsia 2.8% |
Individual cardiovascular outcomes by subtype
- All subtypes were associated with increased risks of heart failure and stroke
- Most subtypes were associated with higher cardiovascular mortality
- Unspecified hypertension was associated with myocardial infarction
- Chronic hypertension and unspecified hypertension were associated with atrial fibrillation
Original publication
Hypertensive Disorders of Pregnancy Subtypes and Long-Term Cardiovascular Risk. JAMA Intern Med. Published 1 April 2026. doi:10.1001/jamainternmed.2025.7802
Summarised from the published abstract; every number is checked against it