Chronic hypertension in pregnancy increases 13-fold in 40 years

  • Ananth CV & al.
  • Hypertension
  • 9 Sep 2019

  • International Clinical Digest
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Takeaway

  • The prevalence of chronic hypertension in pregnancy has increased more than 13-fold in the last 40 years, even as racial disparities persisted through that period.
  • Older maternal age is one reason for the increase, but some other candidate factors are modifiable.

Why this matters

  • Women are delaying pregnancy and childbirth because of social forces, but lifestyle-related factors involved in hypertension of pregnancy need emphasis.
  • These include maintaining a healthy nonpregnant weight and BP, not smoking, and taking preventive measures against type 2 diabetes. 
  • Race disparities also need focus. 

Key results

  • Rate of chronic hypertension during pregnancy increased by about 6% each year during the study period, more so for white women (7%; 95% CI, 6%-7%) than black women (4%; 95% CI, 3%-4%). 
  • However, although the prevalence of chronic hypertension in pregnancy was 0.63% overall, it was 1.24% among black women vs 0.53% among white women:
    • Rate ratio: 2.31 (95% CI, 2.30-2.32).
  • Age was associated with increased rate of chronic hypertension during pregnancy.

Study design

  • Population-based cross-sectional study, 151 million women who delivered in a US hospital, 1970-2010.
  • Funding: None.

Limitations

  • Diagnostic criteria changes might explain some of the increase.
  • Potential inaccuracies in data recording.
  • Trends in antihypertensive treatment not known.

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