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Women With Hypertension in Pregnancy Show Greater Cognitive Decline Later in Life
High blood pressure during pregnancy is associated with a heightened risk of cognitive issues in older age, according to study findings published in Neurology.
“While high blood pressure during pregnancy, including preeclampsia, is recognized as a risk factor for heart disease and stroke, our study suggests that it may also be a risk factor for cognitive decline in later life,” said study corresponding author Michelle M. Mielke, PhD, Wake Forest University School of Medicine in Winston-Salem, North Carolina.
The study included 2239 women, median age 73, from the Mayo Clinic Study of Aging. Among them, 1854 had at least one pregnancy: 100 with gestational high blood pressure, 147 with preeclampsia or eclampsia, and 1607 with normal blood pressure. Participants underwent 9 different cognitive tests every 15 months over an average 5 years.
Women who experienced high blood pressure when pregnant showed greater decline on tests of global cognition, attention, executive function, and language, according to the study, compared with women who had normal blood pressure when pregnant or women who had never given birth.
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After researchers adjusted for age and education, they found women with any type of high blood pressure disorder averaged a 0.3-point decline in a composite score of all memory and thinking tests, while women without high blood pressure during pregnancy averaged a 0.05-point decline. When stratified by type of high blood pressure, women with preeclampsia had a decline of 0.04 points compared with of 0.05 for women with other blood pressure disorders and for women without blood pressure disorders.
Adjusted analysis also found women with high blood pressure in pregnancy declined 0.4 standard deviation on executive function and attention tests over 5 years, compared with 0.1 standard deviation for those with normal blood pressure during pregnancy. Again, results were more pronounced for women with preeclampsia, who had a 0.5 standard deviation decrease.
Because most study participants were white, the results may not be generalizable to more diverse populations, the authors advised.
“More research is needed to confirm our findings,” said Dr Mielke. “However, these results suggest that managing and monitoring blood pressure during and after pregnancy is an important factor for brain health later in life.”
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