Impact of a History of Hypertension in Pregnancy on Later Diagnosis of Atrial Fibrillation

BackgroundAtrial fibrillation/flutter (AF) produces significant morbidity in women and is typically attributed to cardiac remodeling from multiple causes, particularly hypertension. Hypertensive pregnancy disorders (HPDs) are associated with future hypertension and adverse cardiac remodeling. We eva...

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Autores principales:	Dawn C. Scantlebury, Andrea G. Kattah, Tracey L. Weissgerber, Sanket Agarwal, Michelle M. Mielke, Amy L. Weaver, Lisa E. Vaughan, Stanislav Henkin, Katherine Zimmerman, Virginia M. Miller, Wendy M. White, Sharonne N. Hayes, Vesna D. Garovic
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2018
Materias:	atrial fibrillation hypertension obesity preeclampsia/pregnancy women Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/f48f87f558bd443ea8991606d0d62225
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spelling	oai:doaj.org-article:f48f87f558bd443ea8991606d0d622252021-11-12T17:01:52ZImpact of a History of Hypertension in Pregnancy on Later Diagnosis of Atrial Fibrillation10.1161/JAHA.117.0075842047-9980https://doaj.org/article/f48f87f558bd443ea8991606d0d622252018-05-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.117.007584https://doaj.org/toc/2047-9980BackgroundAtrial fibrillation/flutter (AF) produces significant morbidity in women and is typically attributed to cardiac remodeling from multiple causes, particularly hypertension. Hypertensive pregnancy disorders (HPDs) are associated with future hypertension and adverse cardiac remodeling. We evaluated whether women with AF were more likely to have experienced a HPD compared with those without. Methods and ResultsA nested case–control study was conducted within a cohort of 7566 women who had a live or stillbirth delivery in Olmsted County, Minnesota between 1976 and 1982. AF cases were matched (1:1) to controls based on date of birth, age at first pregnancy, and parity. AF and pregnancy history were confirmed by chart review. We identified 105 AF cases: mean age 57±8 (mean±SD) years, (controls 56±8 years), 32±8 years (controls 31±8 years) after the first pregnancy. Cases were more likely to have obesity during childbearing years, and hypertension, diabetes mellitus, dyslipidemia, coronary disease, valvular disease, and heart failure at the time of AF diagnosis. Cases were more likely to have a history of HPDs, compared with controls: 28/105 (26.7%) cases versus 12/105 (11.4%) controls, odds ratio: 2.60 (95% confidence interval, 1.21–6.04). After adjustment for hypertension and obesity, the association was attenuated and no longer statistically significant; odds ratio (95% confidence interval, 2.12 (0.92–5.23). ConclusionsWomen with AF are more likely to have had a HPD, a relationship at least partially mediated by associated obesity and hypertension. Given the high morbidity of AF, studies evaluating the benefit of screening for and management of cardiovascular risk factors in women with a history of HPD should be performed.Dawn C. ScantleburyAndrea G. KattahTracey L. WeissgerberSanket AgarwalMichelle M. MielkeAmy L. WeaverLisa E. VaughanStanislav HenkinKatherine ZimmermanVirginia M. MillerWendy M. WhiteSharonne N. HayesVesna D. GarovicWileyarticleatrial fibrillationhypertensionobesitypreeclampsia/pregnancywomenDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 7, Iss 10 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	atrial fibrillation hypertension obesity preeclampsia/pregnancy women Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	atrial fibrillation hypertension obesity preeclampsia/pregnancy women Diseases of the circulatory (Cardiovascular) system RC666-701 Dawn C. Scantlebury Andrea G. Kattah Tracey L. Weissgerber Sanket Agarwal Michelle M. Mielke Amy L. Weaver Lisa E. Vaughan Stanislav Henkin Katherine Zimmerman Virginia M. Miller Wendy M. White Sharonne N. Hayes Vesna D. Garovic Impact of a History of Hypertension in Pregnancy on Later Diagnosis of Atrial Fibrillation
description	BackgroundAtrial fibrillation/flutter (AF) produces significant morbidity in women and is typically attributed to cardiac remodeling from multiple causes, particularly hypertension. Hypertensive pregnancy disorders (HPDs) are associated with future hypertension and adverse cardiac remodeling. We evaluated whether women with AF were more likely to have experienced a HPD compared with those without. Methods and ResultsA nested case–control study was conducted within a cohort of 7566 women who had a live or stillbirth delivery in Olmsted County, Minnesota between 1976 and 1982. AF cases were matched (1:1) to controls based on date of birth, age at first pregnancy, and parity. AF and pregnancy history were confirmed by chart review. We identified 105 AF cases: mean age 57±8 (mean±SD) years, (controls 56±8 years), 32±8 years (controls 31±8 years) after the first pregnancy. Cases were more likely to have obesity during childbearing years, and hypertension, diabetes mellitus, dyslipidemia, coronary disease, valvular disease, and heart failure at the time of AF diagnosis. Cases were more likely to have a history of HPDs, compared with controls: 28/105 (26.7%) cases versus 12/105 (11.4%) controls, odds ratio: 2.60 (95% confidence interval, 1.21–6.04). After adjustment for hypertension and obesity, the association was attenuated and no longer statistically significant; odds ratio (95% confidence interval, 2.12 (0.92–5.23). ConclusionsWomen with AF are more likely to have had a HPD, a relationship at least partially mediated by associated obesity and hypertension. Given the high morbidity of AF, studies evaluating the benefit of screening for and management of cardiovascular risk factors in women with a history of HPD should be performed.
format	article
author	Dawn C. Scantlebury Andrea G. Kattah Tracey L. Weissgerber Sanket Agarwal Michelle M. Mielke Amy L. Weaver Lisa E. Vaughan Stanislav Henkin Katherine Zimmerman Virginia M. Miller Wendy M. White Sharonne N. Hayes Vesna D. Garovic
author_facet	Dawn C. Scantlebury Andrea G. Kattah Tracey L. Weissgerber Sanket Agarwal Michelle M. Mielke Amy L. Weaver Lisa E. Vaughan Stanislav Henkin Katherine Zimmerman Virginia M. Miller Wendy M. White Sharonne N. Hayes Vesna D. Garovic
author_sort	Dawn C. Scantlebury
title	Impact of a History of Hypertension in Pregnancy on Later Diagnosis of Atrial Fibrillation
title_short	Impact of a History of Hypertension in Pregnancy on Later Diagnosis of Atrial Fibrillation
title_full	Impact of a History of Hypertension in Pregnancy on Later Diagnosis of Atrial Fibrillation
title_fullStr	Impact of a History of Hypertension in Pregnancy on Later Diagnosis of Atrial Fibrillation
title_full_unstemmed	Impact of a History of Hypertension in Pregnancy on Later Diagnosis of Atrial Fibrillation
title_sort	impact of a history of hypertension in pregnancy on later diagnosis of atrial fibrillation
publisher	Wiley
publishDate	2018
url	https://doaj.org/article/f48f87f558bd443ea8991606d0d62225
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Impact of a History of Hypertension in Pregnancy on Later Diagnosis of Atrial Fibrillation

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