Hypertensive Disorders of Pregnancy Associated With Increased Risk for Cardiovascular Disease in Women With SLE

Hypertensive disorders of pregnancy (HDPs) in women with systemic lupus erythematosus (SLE) is associated with an increased risk for cardiovascular outcomes, including stroke and acute myocardial, according to a brief report published in Arthritis Care & Research.

Previous studies have shown that HDPs are associated with increased cardiovascular disease incidence in women. In addition, it has also been observed that preeclampsia is associated with a higher incidence of cardiovascular events, including stroke.

The objective of the current study was to explore the association between HDPs and risk for cardiovascular disease in women with and without SLE.

Using the Swedish Medical Birth Register, all singleton pregnancies between 1987 and 2012 were identified. Data from the National Patients Register were used to identify discharge diagnoses for HDPs, cardiovascular morbidity, and hypertension.

A total of 450 singleton first deliveries among women with SLE and 2890 singleton first deliveries among women without SLE were identified. Hypertensive disorders of pregnancy were reported in 90 of 450 women with SLE, compared with 200 of 2890 women without SLE (20% vs 7%, respectively).

Compared with women with SLE without HDPs, those with SLE with HDPs had a 2-fold higher rate of cardiovascular outcomes after pregnancy. In addition, among women with and without SLE, HDPs were associated with a 3-fold higher incidence of hypertension.

The HDPs explained 10% of the association between SLE and cardiovascular outcomes and 20% of the association between the SLE and hypertension.

Study limitations included the limited power due to sparse events and relying solely on International Statistical Classification of Diseases (ICD) codes to assess outcomes and missing data on antiphospholipid antibodies.

“In women with SLE and those without SLE, HDPs were associated with a 3-fold higher rate of hypertension. In SLE, women with HDPs developed cardiovascular outcomes twice as often as women without HDPs,” the researchers concluded.

Reference

Simard JF, Rossides M, Arkema EV, et al. Maternal Hypertensive disorders in pregnant women with systemic lupus erythematosus and future cardiovascular outcomes. Arthritis Care Res (Hoboken). 2021;73(4):574-579. doi:10.1002/acr.24160