USA: A recent study in the Journal of the American College of Cardiology (JACC) has reported that women with pre-eclampsia/eclampsia are at increased risk of future heart failure (HF) for up to a decade. The study found eclampsia to be an independent risk factor for future hospitalizations for HF with preserved ejection fraction (HFpEF).
While the previous studies have shown preeclampsia to be associated with increased risk of furtire HF, the relationship between preeclampsia and HF subtypes are not well-established. To determine the same, Dominique Williams, Washington University in St Louis, St Louis, Missouri, USA, and colleagues aimed to identify the risk of HFpEF following a delivery complicated by preeclampsia/eclampsia in a retrospective cohort study.
The study identified delivery hospitalizations between 2006 and 2014 for women with and without preeclampsia/eclampsia using the New York and Florida state Healthcare Cost and Utilization Project State Inpatient Databases. The researchers identified women admitted for HF after discharge from index delivery hospitalization until September 30, 2015. Patients were followed from discharge to the first instance of primary outcome (HFpEF hospitalization), death, or end of study period. The association between preeclampsia/eclampsia and HFpEF was analyzed.
The study included 2,532,515 women: 2,404,486 without and 128,029 with preeclampsia/eclampsia.
Based on the study, the researchers found the following:
· HFpEF hospitalization was significantly more likely among women with preeclampsia/eclampsia, after adjusting for baseline hypertension and other covariates (aHR: 2.09).
· Median time to onset of HFpEF was 32.2 months, and median age at HFpEF onset was 34.0 years.
· Both traditional (hypertension, diabetes mellitus) and sociodemographic (Black race, rurality, low income) risk factors were also associated with HFpEF and secondary outcomes.
The authors concluded, "Preeclampsia/eclampsia is an independent risk factor for future hospitalizations for HFpEF."
"These findings are particularly important as HFpEF disproportionately affects women and can be challenging to treat," they noted. "Increased education, screening, and lifestyle modifications and pharmacologic therapies may potentially be beneficial to reduce their risk."
Reference:
The study titled, "Preeclampsia Predicts Risk of Hospitalization for Heart Failure With Preserved Ejection Fraction," is published in the Journal of the American College of Cardiology.
DOI: https://www.jacc.org/doi/abs/10.1016/j.jacc.2021.09.1360