Pregnancy Induced Hypertension (PIH): Beyond Pregnancy

Contrary to the belief that pregnancy-induced hypertension (PIH,or hypertensive disorders of pregnancy, HDP) and preeclampsiaare benign conditions that do not extend harm past pregnancy, theevidence is growing that preeclampsia is a risk factor for futurecardiovascular disease. Although most published data indicatethat proteinuria during pregnancy does no long-term harm to themother, more recent reports indicate that preeclampsia increasesthe risk of cardiovascular disease [1-7]. Recent research publishedon November 11, 2019 in the Journal of the American College ofCardiology confirms that women who have gestational hypertensionor preeclampsia in at least one pregnancy have a higher cardiovascularrisk than women without this history [7]. The authors concludethat a history of HDP can be a useful tool to refine atheroscleroticcardiovascular disease risk assessments. They added “However,future risk of diverse cardiovascular conditions in asymptomaticmiddle-aged women with prior HDP remains unknown”. They alsoargued that “hypertensive disorders of pregnancy are associated withaccelerated cardiovascular aging and more diverse cardiovascularconditions than previously appreciated”, and commented that thecardiovascular risk after HDP is largely but not solely mediated bythe development of chronic hypertension. Many authorities nowregard pregnancy as a “cardiovascular stress test” [8].