ArticleHypertension (Dallas, Tex. : 1979)2026
Lifetime Adverse Pregnancy Outcome History and Cardiovascular Risk.
Tiange Liu, Hanne Dahl Vonen, Ricardo Henao, Michael J Pencina, Kathryn M Rexrode, Chuan Hong, Johanna Quist-Nelson, Marie-Louise Meng, Jennifer J Stuart, Michael C Honigberg and 3 more
Abstract read
In one paragraphArticle in Hypertension (Dallas, Tex. : 1979), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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2 · The registryThe trial behind it
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5 · Who and what moneyAuthors and funding
13 authors.
Tiange LiuDivision of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (T.L., K.M.R., J.J.S., J.W.R.-E.).ORCID 0000-0003-2486-8691 Hanne Dahl VonenDepartment of Epidemiology (H.D.V., J.E.C., J.W.R.-E.), Harvard T.H. Chan School of Public Health, Boston, MA.ORCID 0000-0003-3952-3856 Ricardo HenaoDepartment of Biostatistics and Informatics, Duke University, Durham, NC (R.H., M.J.P., C.H.).ORCID 0000-0003-4980-845X Michael J PencinaDepartment of Biostatistics and Informatics, Duke University, Durham, NC (R.H., M.J.P., C.H.).ORCID 0000-0002-1968-2641 Kathryn M RexrodeDivision of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (T.L., K.M.R., J.J.S., J.W.R.-E.).ORCID 0000-0003-3387-8429 Chuan HongDepartment of Biostatistics and Informatics, Duke University, Durham, NC (R.H., M.J.P., C.H.).ORCID 0000-0001-7056-9559 Johanna Quist-NelsonDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The University of North Carolina at Chapel Hill, Chapel Hill, NC (J.Q.-N.).ORCID 0000-0003-3390-5239 Marie-Louise MengDepartment of Anesthesiology, Duke University Medical Center, Durham, NC (M.-L.M.).ORCID 0000-0001-8089-3993 Jennifer J StuartDivision of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (T.L., K.M.R., J.J.S., J.W.R.-E.).ORCID 0000-0003-2718-8827 Jorge E ChavarroDepartment of Epidemiology (H.D.V., J.E.C., J.W.R.-E.), Harvard T.H. Chan School of Public Health, Boston, MA.ORCID 0000-0002-4436-9630 Kenneth J MukamalDepartment of Nutrition (J.E.C., K.J.M.), Harvard T.H. Chan School of Public Health, Boston, MA.ORCID 0000-0001-8450-6970 Janet W Rich-EdwardsDivision of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (T.L., K.M.R., J.J.S., J.W.R.-E.).ORCID 0000-0001-5066-8808 Funding
Life Course Cancer Epidemiology Cohort in WomenU01CA176726 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI ELIASSEN, A. HEATHER, WILLETT, WALTER C. · 2018 to 2025
$22.4MDietary Etiology of Heart DiseaseR01HL035464 · NHLBI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI ERIC B RIMM, Qi Sun · 1986 to 2026
$13.6MPremonopausal Hormone Levels and Risk of Breast CancerR01CA067262 · NCI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI HANKINSON, SUSAN E · 2002 to 2011
$11.9MLeveraging machine learning for cardiovascular disease risk prediction and prevention in women with a history of adverse pregnancy outcomesR01HL167960 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI Ricardo Henao Giraldo, JANET W RICH-EDWARDS · 2024 to 2026
$2.6MEffects of IL-1 beta inhibition on vascular inflammation in TET2 clonal hematopoiesisR01HL173028 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI Michael Honigberg, Mabel Toribio · 2025 to 2026
$1.7MClonal hematopoiesis as a mediator of cardiovascular disease in women with premature menopauseK08HL166687 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI HONIGBERG, MICHAEL · 2023 to 2025
$507kAmerican Heart Association-American Stroke Association 24RGRSG1275749American Heart Association-American Stroke Association 25SFRNCCKMS1443062American Heart Association-American Stroke Association 25SFRNPCKMS1463898NCI NIH HHS R01 CA067262NCI NIH HHS U01 CA176726NHLBI NIH HHS K08 HL166687NHLBI NIH HHS R01 HL035464NHLBI NIH HHS R01 HL167960NHLBI NIH HHS R01 HL173028
6 · The paper itselfAbstract
backgroundFew studies have examined how multiple types of adverse pregnancy outcomes across women's reproductive lives relate to long-term cardiovascular disease.
methodsIn 59 154 parous participants in Nurses' Health Study II, lifetime history of gestational diabetes, gestational hypertension, preeclampsia, preterm delivery, and low birth weight was self-reported, and cardiovascular events, including myocardial infarction, stroke, and coronary revascularization, were identified through June 2017. We used Cox proportional hazards models to estimate associations between adverse pregnancy outcomes and cardiovascular disease and quantified the extent to which these associations were explained by the later development of hypertension, diabetes, and hypercholesterolemia. We evaluated whether adding adverse pregnancy outcomes improved prediction of premature cardiovascular disease beyond established risk factors such as systolic blood pressure and diabetes.
resultsEach adverse pregnancy outcome was associated with a higher risk of long-term cardiovascular disease. Only gestational hypertension (hazard ratio, 1.62 [95% CI, 1.36-1.92]) and preeclampsia (1.31 [1.11-1.55]) retained independent associations after accounting for the cooccurrence of other adverse pregnancy outcomes. Postpregnancy hypertension, diabetes, and hypercholesterolemia jointly accounted for substantial attenuation (58.4% [38.7%-75.8%]) of the association between adverse pregnancy outcomes in the first pregnancy and later cardiovascular disease. Adding adverse pregnancy outcomes only modestly improved discrimination and slightly improved reclassification.
conclusionsCommon adverse pregnancy outcomes, especially gestational hypertension and preeclampsia, are associated with higher future cardiovascular risk, with much of this association attenuated after accounting for subsequent cardiovascular risk factors. However, given the limited predictive gains, more nuanced integration of adverse pregnancy outcomes is needed to enhance their clinical utility in cardiovascular risk prediction.
Indexed as
Cardiovascular DiseasesHypertension, Pregnancy-InducedPregnancy OutcomeAdultDiabetes, GestationalFemaleHeart Disease Risk FactorsHumansPre-EclampsiaPregnancyPremature BirthRisk AssessmentRisk Factorscardiovascular diseaseshypertension, pregnancy-inducedpre-eclampsiapregnancy complicationswomen’s health
Identifiers
PMID41859799
PMCPMC13052219
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