208. Risk of cardiovascular mortality in women with a history of hypertensive pregnancy disorders: A nationwide cohort study

Introduction Hypertensive pregnancy disorders (HPD) are associated with cardiovascular disease (CVD) later in life. Since hypertension in pregnancy occurs at a relatively young age this may signal an opportunity for preventive measure for CVD at a relative early age. This study investigated the relationship between HPD and cardiovascular mortality in a large national cohort. Methods Women who gave birth during 1995–2015 (registered in the Dutch National Birth Registry) were linked with the National Death Registry. The risk of cardiovascular mortality (CVM) after HPD was analyzed prospectively in two different cohorts: Women with a history of HDP in one or more pregnancies and HDP in the first pregnancy of the women. Cox-regression models with survival curves were executed. Results Of 1,625,246 parous women 21.9% had a history of HDP. Both gestational hypertension (GH; 18.1%) and preeclampsia (PE; 3.8%) were associated with a 2–3 times higher CVM risk compared to women without a history of HPD. Similar results were found in the cohort of 1,243,890 women whose first nulliparous pregnancy was analyzed. Women with HDP, delivery 110 mmHg had a 4.5-fold higher CVM-risk. Women were followed for a mean time of 10.4 years and died at a mean age of 40 years old. Conclusion Women with a history of HDP have a 2–3-fold times higher CVM risk. Cardiovascular mortality risk is present at a relatively young age (