Hypertensive disorders of pregnancy linked to development of dementia

U.S.A.: According to a study published in the journal Hypertension, maternal history of hypertensive disorders of pregnancy (HDP) is a significant risk factor for the subsequent development of vascular and all-cause dementia.

In up to 10% of pregnancies globally, hypertensive disorder of pregnancy (HDP) is one of the major causes of maternal and fetal morbidity and mortality. Women with a history of hypertensive disorders of pregnancy are 2- to 4-times more likely to have cardiovascular disease later in life. Given HDP's vascular origin, it was speculated that it could possibly increase the likelihood of developing dementia in the future.

The authors sought to evaluate the data supporting link of hypertensive disorder of pregnancy (HDP) to dementia and to take into account any particular connections between HDP and different kinds of dementia.

Online electronic databases were searched for observational studies on the association between HDP and dementia through July 1, 2021. The researchers took into account observational studies where women were exposed to HDP of any subtype, including pregnancy hypertension, preeclampsia/eclampsia, or other/unspecified HDP. Any dementia and dementia subtypes, including Alzheimer's disease, vascular dementia, and other/unspecified dementias, were the results. They used 5 cohort studies with a total of 183 874 women with HDP and 2,309,705 women without HDP for the main analysis.

Key highlights of the study:

• When comparing women with and without any sort of HDP, pooled analysis revealed a 38% increased risk of dementia (adjusted hazard ratio, 1.38 [95% CI, 1.18-1.61]; P<0.01).
• women with any form of HDP had a risk of vascular dementia that was over three times higher than women without HDP (adjusted hazard ratio, 3.14 [95% CI, 2.32-4.24]; P<0.01). This was determined by looking at associations between HDP and dementia subtypes.

Karen C. Schliep, PhD, and team concluded that their analyses demonstrate maternal history of HDP to be a major risk factor for emergence of vascular and all-cause dementia.

More investigation on the impact of HDP on vascular dementia in particular and dementia from all causes in general among more racially and ethnically varied groups is necessary, they added.

REFERENCE

Schliep KC, Mclean H, Yan B, Qeadan F, Theilen LH, Havenon ADE, Majersik JJ, Østbye T, Sharma S, Varner MW. Association Between Hypertensive Disorders of Pregnancy and Dementia: a Systematic Review and Meta-Analysis. Hypertension. 2022 Nov 8. doi: 10.1161/HYPERTENSIONAHA.122.19399. Epub ahead of print. PMID: 36345823.