Hypertensive Disorders of Pregnancy Tied to Stroke Risk
However, primary preventive treatment with aspirin may cut long-term risk for stroke
MONDAY, March 4, 2019 (Pharmacist's Briefing) -- Women with a history of hypertensive disorders of pregnancy (HDP) have a greater long-term risk for stroke that is reduced by aspirin use, according to a study recently published in Neurology.
Eliza C. Miller, M.D., from the Columbia University Mailman School of Public Health in New York City, and colleagues analyzed data from 83,749 women participating in the California Teachers Study. Patients were enrolled in 1996 (≤60 years of age) and were followed through 2015 using data linked with California hospital records.
The researchers found that 4.9 percent of the women had HDP. There was an increased risk for all stroke among women with prior HDP (adjusted hazard ratio [HR], 1.3; 95 percent confidence interval [CI], 1.2 to 1.4). However, there was no increased risk for stroke before age 60 (adjusted HR, 1.2; 95 percent CI, 0.9 to 1.7). There was an interaction between aspirin use and HDP history on risk for stroke before age 60 years (P = 0.18), with nonusers of aspirin having a higher risk (adjusted HR, 1.5; 95 percent CI, 1 to 2.1) not seen in aspirin users (adjusted HR, 0.8; 95 percent CI, 0.4 to 1.7). No effect was seen with statins.
"A history of preeclampsia is currently not considered when calculating 10-year cardiovascular risk, but it probably needs to be incorporated into risk-estimation guidelines," Miller said in a statement. "Some women with this history may need primary preventive treatment with aspirin, even in the absence of additional vascular risk factors."