Gestational hypertension linked to long-term cerebrovascular risk: Study

A new study published in the journal of Hypertension showed that the white matter hyperintensity volume was higher 15 years later (Beta: 0.39), suggesting cerebral small artery disease, among women who had previously experienced hypertensive disorders during pregnancy, especially gestational hypertension.

Due to their shared risk factors, cardiovascular disease (CVD) and cerebrovascular illness, including dementia, continue to rank among the world's leading causes of mortality and disability. There are significant sex variations in the impact of risk variables like hypertension on cerebrovascular illness, despite the fact that men and women share numerous risk factors. There are also other cardiovascular risk factors that are unique to women. Pregnancy and its consequences, such hypertensive disorders of pregnancy (HDP), are especially linked to a number of these variables.

There is strong evidence linking pregnancy-related hypertension problems to long-term cerebrovascular health. Thus, to ascertain the relationships between indicators of cerebral small vessel disease 15 years after pregnancy and hypertensive disorders of pregnancy, Rowina Hussainali and colleagues carried out this investigation.

A population-based prospective cohort that was tracked from the beginning of pregnancy included this nested cohort study. Of the 538 women researchers included, 445 (82.8%) had normotensive index pregnancies, and 93 (17.2%) had hypertension illnesses. Women who had magnetic resonance imaging 15 years after the index pregnancy (median, 14.6 years; 90% range, 14.0-15.7 years) had their brain tissue and white matter hyperintensity volume, cerebral microhemorrhages and lacunar infarcts evaluated as indicators of cerebral small artery disease.

The white matter hyperintensity volume was larger in women with a history of hypertensive disorders of pregnancy than in those with a history of normotensive pregnancy (adjusted β, 0.32 [95% CI, 0.08-0.56]).

Women with gestational hypertension were the ones who drove this connection; their white matter hyperintensity volume was larger than that of women who had previously experienced a normotensive pregnancy (adjusted β, 0.39 [95% CI, 0.10-0.67]).

Those with gestational hypertension who experienced chronic hypertension following the index pregnancy experienced a greater impact. There were no variations in cerebral microhemorrhages or infarcts.

Overall, when compared to women with normotensive pregnancies, those with a history of hypertensive disorders of pregnancy, namely gestational hypertension, had some symptoms of cerebral small vessel disease in a prospective cohort of midlife Dutch women. 

Source:

Hussainali, R. F., Adank, M. C., Lamballais, S., Vernooij, M. W., Ikram, M. A., Steegers, E. A. P., Miller, E. C., & Schalekamp-Timmermans, S. (2025). Hypertension in pregnancy linked to cerebral small vessel disease 15 years later. Hypertension. https://doi.org/10.1161/HYPERTENSIONAHA.124.24544