Association of Hypertensive Disorders of Pregnancy With Future Cardiovascular Disease
| Autor: | Bilal Rayes, Maddalena Ardissino, Eric A. W. Slob, Kiran Haresh Kumar Patel, Joanna Girling, Fu Siong Ng |
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| Přispěvatelé: | British Heart Foundation, Applied Economics, Slob, Eric [0000-0002-1644-0735], Apollo - University of Cambridge Repository |
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
Heart Failure
General Medicine Coronary Artery Disease Hypertension Pregnancy-Induced Mendelian Randomization Analysis Diabetes Mellitus Type 2 Pre-Eclampsia SDG 3 - Good Health and Well-being Pregnancy Cardiovascular Diseases Atrial Fibrillation Humans Female Eclampsia Genome-Wide Association Study Ischemic Stroke |
| Zdroj: | JAMA network open, 6(2). American Medical Association |
| ISSN: | 2574-3805 |
| DOI: | 10.1001/jamanetworkopen.2023.0034 |
| Popis: | ImportanceHypertensive disorders in pregnancy (HDPs) are major causes of maternal and fetal morbidity and are observationally associated with future maternal risk of cardiovascular disease. However, observational results may be subject to residual confounding and bias.ObjectiveTo investigate the association of HDPs with multiple cardiovascular diseases.Design, Setting, and ParticipantsA genome-wide genetic association study using mendelian randomization (MR) was performed from February 16 to March 4, 2022. Primary analysis was conducted using inverse-variance-weighted MR. Mediation analyses were performed using a multivariable MR framework. All studies included patients predominantly of European ancestry. Female-specific summary-level data from FinnGen (sixth release).ExposuresUncorrelated (r2Main Outcomes and MeasuresGenetic association estimates for outcomes were extracted from genome-wide association studies of 122 733 cases for coronary artery disease, 34 217 cases for ischemic stroke, 47 309 cases for heart failure, and 60 620 cases for atrial fibrillation.ResultsGenetically predicted HDPs were associated with a higher risk of coronary artery disease (odds ratio [OR], 1.24; 95% CI, 1.08-1.43; P = .002); this association was evident for both gestational hypertension (OR, 1.08; 95% CI, 1.00-1.17; P = .04) and preeclampsia/eclampsia (OR, 1.06; 95% CI, 1.01-1.12; P = .03). Genetically predicted HDPs were also associated with a higher risk of ischemic stroke (OR, 1.27; 95% CI, 1.12-1.44; P = 2.87 × 10−4). Mediation analysis revealed a partial attenuation of the effect of HDPs on coronary artery disease after adjustment for systolic blood pressure (total effect OR, 1.24; direct effect OR, 1.10; 95% CI, 1.02-1.08; P = .02) and type 2 diabetes (total effect OR, 1.24; direct effect OR, 1.16; 95% CI, 1.04-1.29; P = .008). No associations were noted between genetically predicted HDPs and heart failure (OR, 0.97; 95% CI, 0.76-1.23; P = .79) or atrial fibrillation (OR, 1.11; 95% CI, 0.65-1.88; P = .71).Conclusions and RelevanceThe findings of this study provide genetic evidence supporting an association between HDPs and higher risk of coronary artery disease and stroke, which is only partially mediated by cardiometabolic factors. This supports classification of HDPs as risk factors for cardiovascular disease. |
| Databáze: | OpenAIRE |
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