A new study presented at the American Heart Association’s Hypertension Scientific Sessions 2024 reveals that good cardiovascular health during early pregnancy may help mitigate genetic risks for developing hypertensive disorders such as preeclampsia and gestational hypertension. These findings underscore the critical importance of maintaining cardiovascular health before and during pregnancy, potentially offering a pathway to reduce pregnancy-related complications and improve outcomes for both mothers and newborns.
The research, conducted by a team including Vineetha Mathew, a fourth-year M.D. candidate at Tufts University School of Medicine, analyzed data from over 5,000 first-time pregnant individuals. The study utilized the American Heart Association’s Life’s Essential 8 (LE8) scoring system to assess cardiovascular health and a polygenic risk score to determine genetic susceptibility to hypertensive disorders of pregnancy.
Key findings from the study show that favorable cardiovascular health in the first trimester was associated with a 35% to 62% lower risk of developing a hypertensive disorder of pregnancy across all genetic risk groups. This protective effect was consistent even among those with high genetic risk, suggesting that lifestyle factors can play a significant role in offsetting genetic predisposition to these conditions.
The incidence of hypertensive disorders of pregnancy ranged from 11% in individuals with low genetic risk and favorable cardiovascular health to 37% in those with high genetic risk and unfavorable cardiovascular health. Among the cardiovascular health components examined, body mass index, blood pressure, and diet were found to contribute most significantly to the risk of developing these disorders.
Dr. Mathew emphasized the importance of these findings for clinical practice, stating, ‘OB-GYN and primary care professionals should emphasize cardiovascular health improvement, healthier nutrition, weight management and healthy blood pressure to patients who are considering pregnancy.’ This approach aligns with a growing focus on preventive medicine and early intervention strategies.
The study’s limitations include missing cholesterol metrics for about half of the participants in the main analysis. Future research aims to expand the study to include a more diverse population and incorporate cardiovascular health metrics throughout pregnancy, as well as examine risk patterns in subsequent pregnancies.
Donald M. Lloyd-Jones, M.D., Sc.M., FAHA, a past volunteer president of the American Heart Association, commented on the significance of the results, noting that they ‘highlight the importance of the cardiovascular health construct, as measured by the American Heart Association’s Life’s Essential 8 score, across the entire life course including during pregnancy.’
This research provides valuable insights into the potential for lifestyle modifications to improve pregnancy outcomes, even in the face of genetic risk factors. It underscores the importance of preconception and early pregnancy cardiovascular health counseling, offering hope for reducing the incidence of hypertensive disorders of pregnancy and their associated risks to maternal and fetal health.
As the medical community continues to emphasize prevention and early intervention, these findings may inform new guidelines for prenatal care and pregnancy planning, potentially leading to improved outcomes for expectant mothers and their children. The study’s results highlight the complex interplay between genetic and environmental factors in pregnancy health, reinforcing the importance of a holistic approach to maternal care that considers both genetic predisposition and modifiable lifestyle factors.
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