ESC Congress 2026 Abstract · Oct 26, 2026

Hypertensive disorders of pregnancy and long-term risk of incident cardiac arrhythmias: a meta-analysis

By Sebastian S, Patel B, Bimal T et al.

Background: Hypertensive disorders of pregnancy (HDP) are associated with adverse cardiovascular remodeling and long-term cardiovascular morbidity. Although prior studies demonstrate an increased risk of atrial fibrillation following HDP, the relationship between HDP and overall arrhythmia risk has not been comprehensively evaluated. Purpose: To evaluate the association between hypertensive disorders of pregnancy and the long-term risk of incident cardiac arrhythmias, including atrial and ventricular arrhythmias. Methods: We conducted a systematic search of PubMed, Scopus, Cochrane Library, and ScienceDirect for studies reporting incident arrhythmias in women with prior HDP through January 2026. Statistical analyses were performed using RevMan 5.4 with a random-effects model to pool hazard ratios (HRs) and 95% confidence intervals (CIs). Heterogeneity was assessed using Higgins I² statistic. Results: Our analysis included 10 observational studies including 5.84 million women (mean age at pregnancy 29 years) with follow-up ranging from 2 to 36.2 years postpartum. On pooled analysis, women with prior HDP had a significantly higher risk of overall incident arrhythmia compared with those without HDP (HR 1.59; 95% CI 1.33–1.91; p<0.001; I² = 85%). Sensitivity analyses confirmed the robustness and consistent direction of effect. HDP was also associated with increased risks of atrial fibrillation/flutter (HR 1.66; 95% CI 1.31–2.11; p<0.001; I² = 84%) and ventricular arrhythmias (HR 1.42; 95% CI 1.13–1.80; p=0.003; I² = 0%). Conclusion: Women with a history of hypertensive disorders of pregnancy have a significantly increased risk of atrial and ventricular arrhythmias. Recognizing HDP as a sex-specific cardiovascular risk factor may enhance arrhythmic risk stratification and inform targeted preventive strategies.Forest plot for risk of incident arrhythmiaForest plot for AF/VA

doi.org/10.1093/eurheartj/ehag785.3930Open accessPopulations