Hypertension in pregnancy is associated with elevated homocysteine levels later in life

Abstract

OBJECTIVE Hyperhomocysteinemia is associated with an elevated cardiovascular disease risk. We examined whether women with a history of hypertension in pregnancy are more likely to have a high level of serum homocysteine decades after pregnancy. STUDY DESIGN Serum homocysteine was measured at a mean age of 60 years in nulliparous women (n = 216), and women with a history of normotensive (n = 1825) or hypertensive (n = 401) pregnancies who participated in the Genetic Epidemiology Network of Arteriopathy (GENOA) study. Relationships between homocysteine and pregnancy history were examined by linear and logistic regression, controlling for multiple covariates including personal and family history of hypertension, diabetes, obesity, tobacco use, and demographics. RESULTS A history of hypertension in pregnancy, when compared with normotensive pregnancy, was associated with a 4.5% higher serum homocysteine level (P = .015) and 1.60-fold increased odds of having an elevated homocysteine (95% confidence interval, 1.15–2.21; P = .005) after adjusting for potentially confounding covariates. In contrast, a history of normotensive pregnancy, as compared with nulliparity, was associated with a 6.1% lower serum homocysteine level (P = .005) and a 0.49-fold reduced odds of elevated homocysteine levels (95% confidence interval, 0.32–0.74; P < .001). CONCLUSION Homocysteine levels decades after pregnancy are higher in women with a history of pregnancy hypertension, even after controlling for potential confounders. Thus, pregnancy history may prompt homocysteine assessment and risk modification in an attempt at primary prevention of cardiovascular disease.

Impaired Cognition and Brain Atrophy Decades After Hypertensive Pregnancy Disorders

“…2 Our subsequent studies, using either all FBPP cohorts as a whole or the component network cohorts individually, also showed that women with histories of a hypertensive pregnancy disorder were at greater risk for peripheral artery disease, 24 left ventricular hypertrophy, 25 and metabolic abnormalities that increase the risk of CVD, including elevated C-reactive protein 26 and homocysteine. 27 Taken together, these findings identify hypertensive pregnancy disorders as an additional sex-specific CVD risk factor.…”

Homocysteinemia After Hypertensive Pregnancy Disorders at Term

“…Besides the five studies included in the meta-analysis, we found five studies on homocysteine levels after hypertensive pregnancy disorders. [36][37][38][39][40] The cases in these studies differ significantly: studies included women with preeclampsia, women with preeclampsia and pregnancyinduced hypertension, or both. Further, studies included women with preeclampsia at term or preterm pregnancy or included women with severe preeclampsia.…”

“…One study described homocysteine levels in the first days postpartum, 36 where the study by White et al described homocysteine levels in women at the age of 60 years. 38 Since studies were so diverse, we felt that the current study on homocysteine levels at 2.5 years postpartum after hypertensive pregnancy disorders could provide new information. We included cases with hypertensive pregnancy disorders at term because these disorders have a high incidence.…”

Maternal and umbilical homocysteine in preeclampsia

“…A history of hypertension in pregnancy, when compared with normotensive pregnancy, was associated with a 4.5% higher serum homocysteine level and 1.60-fold increased odds of having an elevated after adjusting for potentially confounding covariates. Aa history of normotensive pregnancy, as compared with nulliparity, was associated with a 6.1% lower serum homocysteine level and a 0.49-fold reduced odds of elevated homocysteine levels (25). Other recently investigations they found significantly higher values umbilical homocysteine in womens with severe preeclampsia, but without only indicate some degree of in-utero fetal cardiac cell damage (26).…”