Maintaining good cardiovascular health early in pregnancy may lower the risk of developing hypertension, even among women with a genetic predisposition to the condition, preliminary research presented at the American Heart Association’s Hypertension Scientific Sessions 2024 suggests. The conference, held from September 5–8, featured the findings from a study involving over 5,000 pregnant women.
The research indicates that women with favorable cardiovascular health during early pregnancy faced a 35–62% reduced risk of developing hypertensive disorders of pregnancy, such as gestational hypertension and preeclampsia, compared to those with less favorable cardiovascular health. This association held true across all genetic risk categories.
Hypertensive disorders during pregnancy are significant contributors to maternal and neonatal mortality. Preeclampsia alone is estimated to account for up to 12% of global maternal deaths annually and approximately 25% of fetal and neonatal deaths.
The study employed a polygenic risk score to assess each participant’s genetic susceptibility to hypertensive disorders. Additionally, researchers used the American Heart Association’s Life’s Essential 8 (LE8) scoring system to evaluate the impact of cardiovascular health on this risk.
“We aimed to determine if there was a relationship between cardiovascular health in early pregnancy and the likelihood of developing hypertensive disorders, even for those with genetic risk,” said Vineetha Mathew, a fourth-year MD candidate at Tufts University School of Medicine and co-author of the study.
The analysis classified participants’ genetic risk using a validated polygenic risk score, which aggregates the effects of numerous genetic variants. Cardiovascular health was assessed using a modified LE8 score, which includes components such as diet, physical activity, sleep, nicotine exposure, diabetes, baseline blood pressure, and body mass index. Cholesterol levels were included for a subset of participants (47%) where available.
Mathew noted, “Our findings suggest that individuals with high genetic risk but favorable cardiovascular health had comparable or even superior outcomes compared to those with low genetic risk but poor cardiovascular health.”
The study highlights the importance of cardiovascular health counseling before and during early pregnancy. “It is crucial for OB-GYNs and primary care physicians to promote cardiovascular health improvements, including better nutrition, weight management, and maintaining healthy blood pressure for those planning a pregnancy,” Mathew advised.
As the focus of medicine increasingly shifts towards prevention, Mathew emphasized the need to address cardiovascular health even before pregnancy to improve outcomes and reduce the risk of later-life cardiovascular issues.
