Women's Health World Conference 2026

Abstract

Background  Hypertensive disorders of pregnancy double the risk of cardiovascular events.

Objectives To assess whether lifestyle factors can mitigate the risk of premature (<50years) cardiovascular events after a hypertensive disorder of pregnancy diagnosis.

Methods Young (<50years) parous women from the Australian Longitudinal Study on Women’s Health 1973-78 cohort linked with medical records was used to assess whether smoking, alcohol, sleep, breastfeeding, physical activity, body mass index, parity, guideline diets and their components modify the risk of a premature cardiovascular event from a diagnosis of hypertensive disorders of pregnancy. Premature cardiovascular event includes major atherosclerotic and thromboembolic cardiovascular disease. Cox proportional hazards models were used with time-varying covariates.

Results 10,368 parous women, median 16.5years follow-up, 14.4% (1,493/10,368) had a diagnosis of hypertensive disorders of pregnancy and 4.3% (448/10310) had a premature cardiovascular event. A diagnosis of hypertensive disorders of pregnancy (aHR 1.74, 95% CI:1.32–2.31), obesity (aHR 1.60, 95% CI:1.19–2.15) and high saturated fat intake (>319g/day) (aHR 1.67, 95% CI:1.11–2.53) increased the risk of a premature cardiovascular event. Breast-feeding (>16 months) (aHR 0.66, (95% CI:0.49–0.89) and high protein intake (>90g/day) (aHR0.65, 95% CI:0.43–0.96) decreased the risk of a premature cardiovascular event. Adherence to the Australian Recommended Food diet, low glycaemic index and not smoking reduced the risk of a premature cardiovascular event in women without a diagnosis of hypertensive disorders of pregnancy, but there was no benefit among women with a diagnosis of hypertensive disorders of pregnancy (interaction-p-value=0.023, 0.043, 0.005 respectively).

Conclusion This study found that a diagnosis of hypertensive disorders of pregnancy remained associated with an increased risk of a premature cardiovascular event. While breastfeeding, optimal body mass index, low saturated fat and high protein intake were protective against premature cardiovascular events, some lifestyle factors only lowered premature cardiovascular events for women without a diagnosis of hypertensive disorders of pregnancy and not for women with a diagnosis of hypertensive disorders of pregnancy.