Polygenic Risk for Pre-Eclampsia and the Long-Term Risk of Incident Hypertension and Cardiovascular Disease: A Population-Based Cohort Study.

OBJECTIVE

To investigate whether genetic predisposition to pre-eclampsia (PE), measured by a polygenic risk score (PRS), is associated with incident hypertension and cardiovascular disease (CVD) after delivery in Asian women.

DESIGN

Prospective population-based cohort study.

SETTING

Data were utilised from the Korean Genome and Epidemiology Study and additional multicentre cohorts.

POPULATION: 35 872 parous Korean women aged 40-80 years at last surveillance, with genotype data, no history of hypertension or CVD before delivery, and complete clinical information. For external validation, 559 parous Korean women were included.

METHODS

The PE-PRS was calculated for Asian women, and the study population was divided into the high PE-PRS and low PE-PRS groups. The long-term risks of incident hypertension and CVD (ischaemic heart disease or stroke) after delivery were compared between the groups.

MAIN OUTCOME MEASURES: Incident hypertension and CVD after delivery.

RESULTS

Women in the high PE-PRS group had an increased risk of developing hypertension (adjusted hazard ratio [aHR] 1.25, 95% CI 1.17-1.34) and ischaemic heart disease (aHR 1.28, 95% CI 1.07-1.54) compared to the low PE-PRS group. The risk of hypertension was highest among women with both a history of PE and a high PE-PRS.

CONCLUSIONS

Genetic predisposition to PE, as measured by the PE-PRS, is associated with an elevated risk of incident hypertension and ischaemic heart disease in Asian women. These findings suggest the potential utility of the PE-PRS as a complementary tool in assessing individualised hypertension risk in parous women.