Hypertension During Pregnancy Risks Long-Term Cardiovascular Outcomes – Pharmacy Times

Report on Hypertensive Disorders of Pregnancy and Long-Term Cardiovascular Risk in the Context of Sustainable Development Goals

Introduction: Aligning Maternal Health with Global Goals

Recent research highlights a significant correlation between the severity of Hypertensive Disorders of Pregnancy (HDP) and an incremental risk of long-term adverse cardiovascular outcomes and mortality. These findings, presented at the American Heart Association 2025 Scientific Sessions, underscore a critical public health issue that directly impacts the achievement of several Sustainable Development Goals (SDGs), most notably SDG 3: Good Health and Well-being. This report synthesizes the study’s findings, emphasizing the need for strategic health interventions to protect maternal health and reduce premature mortality from non-communicable diseases (NCDs), in line with global development targets.

HDP: A Challenge to SDG 3 (Good Health and Well-being)

Hypertensive Disorders of Pregnancy represent a major obstacle to achieving key targets within SDG 3, which aims to ensure healthy lives and promote well-being for all at all ages.

Understanding the Health Impact

• Definition: HDP encompasses a range of conditions including chronic hypertension, preeclampsia-eclampsia, preeclampsia superimposed on chronic hypertension, and gestational hypertension.
• Short-Term Risks: While many women deliver healthy babies, HDP can cause severe complications, including damage to the mother’s organs, premature delivery, and low birth weight. These outcomes directly challenge SDG Target 3.1, which aims to reduce the global maternal mortality ratio.
• Long-Term Risks: The research confirms that HDP is a significant risk factor for long-term cardiovascular diseases such as coronary artery disease (CAD), aortic stenosis, and mitral regurgitation, contributing to premature mortality from NCDs, a focus of SDG Target 3.4.

Research Methodology and Key Findings

A retrospective analysis conducted by Intermountain Health provides critical data on the long-term consequences of HDP.

Study Overview

1. Cohort: The study included 157,606 unique females across 22 hospitals from 2017 to 2024.
2. Data Analysis: Cox hazard regression analysis was used to examine the association between HDP severity and subsequent cardiovascular outcomes.
3. Prevalence: 19.7% of the cohort experienced HDP, demonstrating the widespread nature of the condition.

Core Findings and Link to Health Inequalities (SDG 10)

• Graded Risk: The 5-year risk of incident stroke, heart failure, CAD, and death increased proportionally with the worsening severity of HDP.
• Compounded Risk Factors: Patients with HDP were more likely to present with additional risk factors, including higher body mass index, smoking, diabetes, and lower socioeconomic status. This finding highlights a critical intersection with SDG 10: Reduced Inequalities, as it indicates that vulnerable populations bear a disproportionate health burden.
• Most Severe Presentations: The highest risk was observed in patients with chronic hypertension (cHTN) with superimposed HDP and eclampsia.

Strategic Implications for Achieving Sustainable Development Goals

The study’s conclusions necessitate a renewed focus on maternal and post-partum care as a cornerstone of sustainable public health policy.

Advancing SDG 3 and SDG 5 (Gender Equality)

Addressing HDP is not only a health imperative but also a crucial step toward gender equality. Protecting women from the long-term consequences of pregnancy-related complications is fundamental to SDG 5: Gender Equality, ensuring their long-term health, well-being, and economic participation.

Recommendations for Action

1. Enhance Awareness: Educate both patients and healthcare providers about the long-term cardiovascular risks associated with any form of hypertension during pregnancy to promote proactive health management.
2. Implement Aggressive Risk Reduction: Develop and deploy targeted cardiovascular risk reduction strategies for women with a history of HDP, beginning in the postpartum period and continuing throughout their lives.
3. Promote Integrated Care: Foster multidisciplinary care models where pharmacists and other health professionals collaborate to manage at-risk women, ensuring comprehensive follow-up and prevention of adverse outcomes.
4. Address Health Disparities: Focus public health initiatives on identifying and supporting women from lower socioeconomic backgrounds and other at-risk groups to mitigate the inequalities highlighted by the research, directly contributing to SDG 10.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  This is the most relevant SDG, as the article focuses entirely on health issues. It discusses hypertensive disorders of pregnancy (HDP), a significant maternal health concern, and its long-term consequences, such as cardiovascular disease and death. The article’s call for “enhanced awareness and aggressive cardiovascular risk reduction strategies” directly supports the goal of ensuring healthy lives and promoting well-being for all at all ages.

• SDG 5: Gender Equality

  The article addresses a health condition that exclusively affects women. By highlighting the severe short- and long-term health risks associated with HDP and advocating for better care, the article implicitly touches upon gender equality in health. Ensuring that women receive appropriate care for pregnancy-related conditions is crucial for addressing health disparities and empowering women to lead healthy lives.

• SDG 10: Reduced Inequalities

  The article notes that patients with HDP were found to have risk factors including “lower socioeconomic status.” This finding connects the health issue to socioeconomic inequality, suggesting that women from disadvantaged backgrounds may be disproportionately affected. The call to “do a better job identifying women with these risk factors and ensuring they receive appropriate care” aligns with the goal of reducing health inequalities within and among countries.

2. What specific targets under those SDGs can be identified based on the article’s content?

• Target 3.1: By 2030, reduce the global maternal mortality ratio.

  The article directly relates to this target by discussing HDP, a leading cause of maternal morbidity and mortality. It states that if preeclampsia develops, “the lives of both the mother and fetus can be threatened,” and highlights that HDP is associated with an increased risk of “death.” The research aims to mitigate these risks through better management.

• Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age.

  The article connects to this target by mentioning that HDP can “lead to an early delivery, and cause low birth weight.” Both premature birth and low birth weight are significant risk factors for neonatal mortality and morbidity. Addressing HDP is therefore a crucial step in improving newborn survival rates.

• Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases (NCDs) through prevention and treatment.

  This is a central theme of the article. The research demonstrates that HDP leads to “incremental risks for long-term cardiovascular outcomes,” including “incident stroke, heart failure, coronary artery disease (CAD), and death.” The call for “aggressive cardiovascular risk reduction strategies” in women with a history of HDP is a direct effort to prevent premature mortality from NCDs.

• Target 3.8: Achieve universal health coverage, including access to quality essential health-care services.

  The article underscores the need for improved healthcare services. It calls for “frequent follow-up visits and comprehensive clinical care” and better identification of at-risk women. This highlights gaps in current care and advocates for more robust and accessible healthcare to manage HDP and its long-term consequences, which is the essence of universal health coverage.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Implied Indicator: Maternal Mortality Ratio (for Target 3.1)

  The article’s focus on the “risk of death” associated with severe HDP implies the maternal mortality ratio as a key indicator. Reducing deaths from conditions like eclampsia would directly lower this ratio.

• Implied Indicator: Proportion of births with low birth weight (for Target 3.2)

  The article explicitly states that HDP can “cause low birth weight.” Therefore, the incidence of low birth weight in babies born to mothers with HDP is an implied indicator for measuring the impact of the condition and the effectiveness of its management.

• Implied Indicator: Mortality rate attributed to cardiovascular disease (for Target 3.4)

  The study’s primary outcome measures were the “5-year risk of incident stroke, heart failure, coronary artery disease (CAD), and death.” These are direct measures of morbidity and mortality from cardiovascular diseases, which are key NCDs. Tracking these rates in women with a history of HDP would be a direct way to measure progress.

• Implied Indicator: Prevalence of risk factors and health outcomes disaggregated by socioeconomic status (for Target 10.2)

  The article identifies “lower socioeconomic status” as a risk factor associated with HDP. This implies that progress towards reducing health inequalities could be measured by tracking the prevalence of HDP and its adverse outcomes across different socioeconomic groups.

4. Create a table with three columns titled ‘SDGs, Targets and Indicators” to present the findings from analyzing the article.

Source: pharmacytimes.com