Gestational Hypertension Linked to Cognitive Decline in new research
Hypertensive disorders of pregnancy, including gestational hypertension, preeclampsia, and eclampsia, are known to have significant implications for maternal and fetal health during pregnancy. However, their potential long-term impact on cognitive function later in life remains unclear, particularly among Hispanic/Latina individuals in the United States.
A recent study conducted as part of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) aimed to address this gap in knowledge. The study was published in the journal Obstetrics and Gynecology. The study was conducted by Elfassy T. and colleagues.
Hypertensive disorders of pregnancy are prevalent and can have serious consequences for both maternal and infant health. Understanding their association with cognitive decline later in life is essential for identifying potential long-term health risks among affected individuals, particularly in diverse populations such as Hispanic/Latina communities in the United States.
The study analyzed data from the HCHS/SOL, a population-based study of Hispanic/Latino individuals aged 18–74 years from four U.S. communities. Participants included parous individuals aged 45 years or older who underwent neurocognitive assessments at two study visits: visit 1 (2008–2011) and visit 2 (2015–2018). Hypertensive disorders of pregnancy were retrospectively assessed, and cognitive functioning was measured using standardized tests. Linear regression models were used to assess the association between hypertensive disorders of pregnancy and cognitive decline, adjusting for various factors.
The key findings of the study were as follows:
The analysis included 3,554 individuals with a mean age of 56.2 years, among whom 13.4% reported at least one hypertensive disorder of pregnancy.
Gestational hypertension was associated with a 0.17-standard deviation (SD) decline in Digit Symbol Substitution scores (95% CI, −0.31 to −0.04) after an average of 7 years of follow-up.
However, neither preeclampsia nor eclampsia was associated with neurocognitive differences.
Individuals with hypertensive disorders of pregnancy had higher mean systolic blood pressure, fasting glucose, and body mass index compared to those without.
The study concludes that among the U.S. Hispanic/Latina individuals, gestational hypertension alone is associated with decreased processing speed and executive functioning later in life. However, there was no significant association observed between preeclampsia or eclampsia and cognitive decline. These findings highlight the importance of identifying and managing gestational hypertension to potentially mitigate the risk of cognitive impairment in later years. Further research is needed to elucidate the underlying mechanisms and develop targeted interventions for at-risk individuals.
Reference:
Elfassy, T., Kulandavelu, S., Dodds, L., Mesa, R. A., Rundek, T., Sharashidze, V., Paidas, M., Daviglus, M. L., Kominiarek, M. A., Stickel, A. M., Perreira, K. M., Kobayashi, M. A., Garcia, T. P., Isasi, C. R., Lipton, R. B., & González, H. M. (2024). Association between hypertensive disorders of pregnancy and interval neurocognitive decline: An analysis of the Hispanic Community Health Study/study of Latinos. Obstetrics and Gynecology, 10.1097/AOG.0000000000005571. https://doi.org/10.1097/aog.0000000000005571
