Study finds pregnancy hypertension raises women’s cardiovascular risk – Nepalnews.com

Report on Hypertensive Disorders of Pregnancy and Long-Term Cardiovascular Risk: Implications for Sustainable Development Goals

Introduction: Addressing Maternal Health in Line with SDG 3

A study by Intermountain Health researchers reveals that Hypertensive Disorders of Pregnancy (HDP) significantly elevate the long-term risk of major cardiovascular events and mortality in women. These findings present a critical challenge to achieving Sustainable Development Goal 3 (Good Health and Well-being), particularly Target 3.1, which aims to reduce the global maternal mortality ratio, and Target 3.4, focused on reducing premature mortality from non-communicable diseases. The research underscores the necessity of viewing pregnancy-related complications as indicators of future health risks that demand sustained medical attention.

Study Overview and Methodology

The retrospective study analyzed data from 218,141 live births across 22 Intermountain Health hospitals between 2017 and 2024. Researchers examined electronic medical records for diagnoses of chronic hypertension and HDP, monitoring patients for an average of five years post-delivery to identify subsequent cardiovascular disease diagnoses.

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

The research identified a direct correlation between HDP and adverse long-term health outcomes, highlighting a significant barrier to ensuring healthy lives for all women.

• Prevalence: 19.7% of patients were diagnosed with a form of HDP.
• Increased Risk Profile: Women with HDP were found to have a significantly higher incidence of cardiovascular risk factors.
• Magnitude of Risk: The presence of HDP was strongly associated with an increased risk for severe cardiovascular events. The specific risk amplifications were:
  • Heart Failure: 3 to 13 times greater risk
  • Stroke: 2 to 17 times greater risk
  • Heart Attack: 3 to 7 times greater risk
  • Coronary Artery Disease: 2 to 7 times greater risk
  • Death: 1.4 to 4 times greater risk
• Severity Correlation: The risk of future cardiovascular events increased with the severity of the HDP, with the highest risk observed in women with chronic hypertension compounded by eclampsia.

Socioeconomic Factors and Reduced Inequalities (SDG 10)

The study links HDP to several risk factors that intersect with social and economic determinants of health, directly relating to SDG 10 (Reduced Inequalities). Addressing HDP is therefore not only a health imperative but also a matter of health equity.

• Associated risk factors included obesity, smoking, diabetes, and depression.
• A significant correlation was found with lower socioeconomic status, indicating that health inequalities exacerbate the risks associated with HDP.

Strategic Recommendations for Advancing SDG 3 and SDG 5

To mitigate these risks and advance SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality), the study’s authors propose a multi-faceted approach focused on proactive and integrated healthcare for women. Ensuring the long-term health of mothers is fundamental to achieving gender equality.

1. Improve Identification and Awareness: Enhance efforts to identify at-risk women and educate them on the long-term cardiovascular risks associated with HDP.
2. Ensure Comprehensive Care: Implement protocols for appropriate and continuous care before, during, and critically, after pregnancy for women with HDP.
3. Promote Cross-Disciplinary Collaboration: Foster an integrated care model that involves not only OB-GYNs but also primary care physicians and cardiologists to manage high-risk patients comprehensively.

Conclusion: The Role of Partnerships for the Goals (SDG 17)

The research highlights an urgent need for a collaborative, “all hands-on deck” clinical model to reduce maternal morbidity and mortality. This approach exemplifies SDG 17 (Partnerships for the Goals), demonstrating that integrating expertise from primary care, cardiology, and obstetrics is essential. Such partnerships are critical to creating a comprehensive clinical framework that can effectively address the long-term health consequences of HDP and contribute to the successful achievement of global health and equality targets.

Analysis of Sustainable Development Goals in the Article

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

   The article primarily addresses issues related to maternal health, non-communicable diseases, and healthcare systems, which directly connect to the following Sustainable Development Goals (SDGs):

   • SDG 3: Good Health and Well-being: This is the most relevant SDG, as the entire article focuses on the health risks (hypertensive disorders and subsequent cardiovascular complications) faced by women during and after pregnancy. It explicitly discusses the need to reduce “maternal morbidity and mortality.”
   • SDG 5: Gender Equality: The article focuses on a health issue that exclusively affects women. Ensuring women’s health and well-being, particularly in relation to pregnancy, is a crucial aspect of gender equality and empowering women to lead healthy, productive lives.
   • SDG 10: Reduced Inequalities: The article mentions that “lower socioeconomic status” is a significant cardiovascular risk factor for patients with Hypertensive Disorders of Pregnancy (HDP). This highlights health disparities linked to economic status, which is a core concern of SDG 10.

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

   Based on the issues discussed, several specific SDG targets can be identified:

   • Target 3.1: “By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.” The article’s concluding statement about the “urgent need for increased awareness, early intervention, and collaborative care to reduce maternal morbidity and mortality” directly aligns with this target.
   • Target 3.4: “By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment…” The research focuses on the long-term risk of non-communicable cardiovascular diseases (heart attack, stroke, heart failure) following HDP. The call for better identification and care for at-risk women is a direct strategy for preventing premature mortality from these conditions.
   • Target 3.8: “Achieve universal health coverage, including… access to quality essential health-care services…” The recommendation for “cross-disciplinary care” involving OB-GYNs, primary care, and cardiology to create a “comprehensive clinical care model” is a call to improve the quality and accessibility of healthcare for this specific high-risk population, which is a key component of universal health coverage.
   • Target 10.2: “By 2030, empower and promote the social, economic and political inclusion of all, irrespective of… economic or other status.” The article identifies “lower socioeconomic status” as a risk factor, implying that women in this group are disproportionately affected. Addressing this disparity is essential to achieving the goal of reducing health inequalities.

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

   The article mentions or implies several indicators that can be used to track progress:

   • Indicator for Target 3.1 (Maternal Mortality): The article directly refers to the risk of “death (1.4 to 4 greater risk)” for women with HDP. This points to the Maternal Mortality Ratio (Indicator 3.1.1) as a key metric. The study’s focus on mortality as an outcome shows its relevance.
   • Indicator for Target 3.4 (Non-communicable Diseases): The study quantifies the increased risk of specific cardiovascular events: “heart failure (3 to 13 greater risk),” “stroke (2-17 greater risk),” and “heart attack (3 to 7 greater risk).” These statistics directly relate to the Mortality rate attributed to cardiovascular disease (Indicator 3.4.1). The prevalence and incidence rates of these conditions in post-partum women serve as direct measures of progress.
   • Implied Indicator for Target 3.8 (Universal Health Coverage): While no official indicator is named, the article’s call for an “‘all hands-on deck’ situation” and an integrated care model implies a need to measure the proportion of high-risk pregnant women receiving comprehensive, multi-disciplinary healthcare. This would serve as a proxy for measuring access to quality essential healthcare services for this group.
   • Implied Indicator for Target 10.2 (Reduced Inequalities): The identification of “lower socioeconomic status” as a risk factor implies the need for data disaggregation. A relevant indicator would be the prevalence of HDP and subsequent cardiovascular events, disaggregated by socioeconomic status, to measure whether health outcome gaps between different economic groups are closing.

SDGs, Targets, and Indicators Table

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