Genome-wide polygenic risk scores for hypertensive disease during pregnancy can also predict the risk for long-term cardiovascular disease.

BACKGROUND: Hypertensive disorders during pregnancy (HDP) are associated with the risk of long-term cardiovascular disease after pregnancy, but it has not yet been determined whether genetic predisposition for HDP can predict the risk for long-term cardiovascular disease.

OBJECTIVE: We aimed to evaluate the risk for long-term atherosclerotic cardiovascular disease (ASCVD) according to polygenic risk scores for HDP (HDP-PRS).

STUDY DESIGN: Among UK Biobank participants, we included European-descent women (n=164,575) with at least one live birth. Subjects were divided according to genetic risk categorized by HDP-PRS (low risk, HDP-PRS ≤25th percentile; medium risk, HDP-PRS 25∼75th percentile; high risk, HDP-PRS >75th percentile) and were evaluated for incident ASCVD, defined as the new occurrence of one of the followings: coronary artery disease, myocardial infarction, ischemic stroke, or peripheral artery disease.

RESULTS: Among the study population, 2,427 (1.5%) had a history of HDP, and 8,942 (5.6%) developed incident ASCVD after enrollment. Women with high genetic risk for HDP had a higher prevalence of hypertension at enrollment. After enrollment, women with high genetic risk for HDP had an increased risk for incident ASCVD, including coronary artery disease, myocardial infarction, and peripheral artery disease compared to those with low genetic risk, even after adjustment for HDP history.

CONCLUSIONS: High genetic risk for HDP was associated with increased risk for ASCVD. This study provides evidence on the informative value of HDP-PRS in prediction of long-term cardiovascular outcomes later in life.