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

Wendy M. White, Stephen T Turner, Kent R Bailey, Thomas H. Mosley, Sharon L R Kardia, Heather J. Wiste, Iftikhar Jan Kullo, Vesna D Garovic

Research output: Contribution to journalArticle

10 Citations (Scopus)

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.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume209
Issue number5
DOIs
StatePublished - Nov 2013

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Homocysteine
Hypertension
Pregnancy
Reproductive History
Serum
Cardiovascular Diseases
Confidence Intervals
Hyperhomocysteinemia
Molecular Epidemiology
Tobacco Use
Primary Prevention
Parity
Linear Models
Obesity
Logistic Models
Demography

Keywords

  • biomarker
  • cardiovascular disease
  • homocysteine
  • hypertension in pregnancy
  • preeclampsia

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Hypertension in pregnancy is associated with elevated homocysteine levels later in life. / White, Wendy M.; Turner, Stephen T; Bailey, Kent R; Mosley, Thomas H.; Kardia, Sharon L R; Wiste, Heather J.; Kullo, Iftikhar Jan; Garovic, Vesna D.

In: American Journal of Obstetrics and Gynecology, Vol. 209, No. 5, 11.2013.

Research output: Contribution to journalArticle

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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.",
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AU - Garovic, Vesna D

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N2 - 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.

AB - 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.

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KW - preeclampsia

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