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Abstract: SA-OR116

Black and Hispanic Women Are at Increased Risk of Hypertension After Preeclampsia

Session Information

Category: Women’s Health and Kidney Diseases

  • 2000 Women’s Health and Kidney Diseases

Authors

  • Larsen, Dana M., Massachusetts General Hospital, Boston, Massachusetts, United States
  • Powe, Camille Elise, Harvard Medical School, Boston, Massachusetts, United States
  • Waikar, Sushrut S., Harvard Medical School, Boston, Massachusetts, United States
  • Karumanchi, S. Ananth, Cedars-Sinai Medical Center, Los Angeles, Massachusetts, United States
  • Thadhani, Ravi I., Cedars-Sinai Medical Center, Los Angeles, Massachusetts, United States
  • Tangren, Jessica Sheehan, Massachusetts General Hospital, Boston, Massachusetts, United States
Background

Preeclampsia is a leading cause of maternal mortality and associated with increased risk of hypertension (HTN) in later life. Black and Hispanic women are at increased risk for pregnancy-related mortality compared to non-Hispanic white women in the United States. We sought to investigate whether long-term complications of preeclampsia are differentially impacted by race/ethnicity. We tested the hypothesis that black and Hispanic women have an increased risk of incident HTN after preeclampsia compared to non-Hispanic white women.

Methods

We analyzed a longitudinal observational cohort of black, Hispanic and non-Hispanic white women who had at least one pregnancy between 1998 and 2014 and were subsequently followed at an academic network of primary care practices through 2018. Patients were followed until incident HTN, using validated diagnostic criteria, or their last encounter in the hospital system. Multivariable Cox proportional hazards models were used to examine the independent association between preeclampsia and risk of incident HTN after delivery. Analyses for effect modification between preeclampsia and non-white race on the risk of HTN were performed.

Results

There were 20,864 women with a pregnancy in the cohort of which 4,959 (23%) and 1,412 (6%) were of self-reported Hispanic or black race/ethnicity, respectively. Preeclampsia developed in 524 (2.5%) of pregnancies. Preeclampsia was associated with an increased risk of incident hypertension after pregnancy in all groups, with higher rates in non-white women (adjusted HR 2.8 [1.9-4.2] p<0.01 for Hispanic women, adjusted HR 2.7 [1.3-5.7] p = 0.01 for black women and adjusted HR 1.8 [1.2-2.8] p<0.01 for non-Hispanic white women. There was evidence of effect modification between non-white race/ethnicity, preeclampsia and incident hypertension (p-interaction=0.04).

Conclusion

Preeclampsia is a major risk factor for later life HTN, particularly among black and Hispanic women.

Funding

  • NIDDK Support