Hypertensive Pregnancy Disorders Associated With CKM Progression

A history of hypertensive disorders of pregnancy (HDP) was associated with a higher cardiovascular-kidney-metabolic (CKM) syndrome stage and with progression to advanced CKM syndrome, according to a study published online in Hypertension.

HDP, which affects more than 10% of pregnancies worldwide, had not previously been examined for their association with CKM syndrome, a framework that stages cardiovascular risk from stage 0 (no risk factors) to stage 4 (cardiovascular disease). Investigators analyzed parous UK Biobank participants, using logistic regression to assess the association between HDP history and CKM stage, adjusted for age, age², race, Townsend Deprivation Index, and smoking status, and Cox models to evaluate progression to stage 4, additionally adjusted for baseline CKM stage. Replication analyses were performed in the Women's Health Initiative, with CKM stage assessed at two study visits.

Among 219,639 UK Biobank participants (mean age, 56.9 years) and 3,591 Women's Health Initiative participants (61.7 years at baseline, 78.1 years at follow-up), 2,836 (1.3%) and 304 (8.4%), respectively, had a history of HDP. In the UK Biobank, HDP history was significantly associated with higher CKM stage (adjusted odds ratio, 3.40; 95% CI, 3.12-3.71). Compared with stage 0, HDP history was associated with higher odds of stages 2 through 4 (adjusted odds ratios of 6.34, 11.20, and 7.43, respectively). Over a median follow-up of 13.6 years, prior HDP was associated with progression to stage 4 (adjusted hazard ratio, 1.24; 95% CI, 1.10-1.40). The Women's Health Initiative replication produced consistent results.

The authors concluded that HDP history was associated with greater CKM stage and progression to advanced CKM syndrome, supporting its potential use as an early-life predictor of adverse CKM trajectories.

Source: Ezzat D, Pabon MA, Li L, et al. Hypertensive disorders of pregnancy and cardiovascular-kidney-metabolic syndrome. Hypertension. Published online 2026. doi:10.1161/HYPERTENSIONAHA.126.27750