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P.076 Hypertensive disorders in pregnancy are strongly associated with future stroke and hypertension: A systematic review and meta-analysis

Published online by Cambridge University Press:  05 January 2022

AR Switzer
Affiliation:
(Calgary)*
EE Smith
Affiliation:
(Calgary)
A Ganesh
Affiliation:
(Calgary)
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Abstract

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Background: We aimed to evaluate the association between hypertensive disorders in pregnancy (HDP) and future risk of stroke, stroke death, and hypertension. Methods: Systematic searches were performed in MEDLINE and EMBASE up to April 27th, 2020. Exposure of interest included the different types of HDP. Outcomes of interest included hypertension incidence, stroke incidence, stroke subtype, and stroke mortality. Results: Eighteen cohort and 1 case-control studies involving >10 million women were included in the meta-analysis. Pooled hazard ratios with 95% confidence interval generally adjusted for age at delivery, ethnicity, and vascular risk factors are listed in table 1. Conclusions: Increasing severities of HDP carry higher hazards of hypertension and stroke years later. HDP, including gestational hypertension alone, are also associated with future stroke mortality.

Table 1.

Pooled adjusted hazard ratios of outcomes for all types of HDP.

OutcomeExposure# of studies includedPooled adjusted Hazard Ratio and 95% confidence intervalsHeterogeneity I2
All strokeAll HDP51.43 (1.22-1.66)80.7%
Chronic hypertension in pregnancy13.40 (2.40-24.0)NA
Gestational hypertension51.38 (1.25-1.52)0%
Preeclampsia121.56 (1.38-1.76)60.7%
Ischemic strokeAll HDP31.72 (1.26-2.35)74.7%
Chronic hypertension in pregnancy22.40 (1.39-4.14)92.1%
Gestational hypertension31.89 (1.34-2.67)61.1%
Preeclampsia42.09 (1.63-2.66)74.9%
Eclampsia14.58 (3.90-5.38)NA
Hemorrhagic strokeAll HDP11.17 (1.24-2.36)NA
Gestational hypertension12.80 (1.31-5.99)NA
Preeclampsia21.42 (1.11-1.82)70.5%
Stroke mortalityAll HDP11.88 (1.53-2.32)NA
Gestational hypertension12.97 (1.49-5.92)NA
Preeclampsia21.45 (0.81-2.60)66.0%
Eclampsia11.56 (0.75-3.23)NA
HypertensionAll HDP22.83 (1.34-6.00)99.8%
Gestational hypertension32.97 (1.54-5.74)99.5%
Preeclampsia62.55 (2.01-3.23)98.7%

Type
Poster Presentations
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation