Summary: Women who have gestational high blood pressure or preeclampsia during pregnancy are at increased risk of cognitive decline as they age.
Disorders of high blood pressure during pregnancy are associated with an increased risk of thinking problems later in life, according to research published in the March 1, 2023 online issue of Neurology.
The researchers found that people with these disorders had a higher risk of cognitive problems later in life than those who did not have high blood pressure during pregnancy.
They also found that people with preeclampsia, which is high blood pressure that develops in mid-pregnancy and usually involves the kidneys and other organs, may have an even higher risk of cognitive decline later in life. , compared to those with gestational high blood pressure, a condition with high blood pressure during pregnancy but without affecting the kidneys or other organs.
“While high blood pressure during pregnancy, including preeclampsia, is recognized as a risk factor for heart disease and stroke, our study suggests it may also be a risk factor for more cognitive decline. later in life,” said study author Michelle M. Mielke, Ph.D., of Wake Forest University School of Medicine in Winston-Salem, North Carolina, and a fellow of the American Academy of Neurology.
The study involved 2,239 participants with an average age of 73. The researchers consulted medical records for information on previous pregnancies.
Among the participants, 1,854 people or 83% had had at least one pregnancy and 385 people or 17% had never had a pregnancy or had a pregnancy of less than 20 weeks. Of those whose pregnancies lasted more than 20 weeks, 100 had gestational high blood pressure, 147 had preeclampsia or eclampsia, and 1,607 had normal blood pressure.
Preeclampsia occurs when there is excess protein in the urine during pregnancy. Eclampsia occurs when high blood pressure during pregnancy causes one or more seizures, sometimes followed by coma.
For the study, participants took nine memory and thinking tests every 15 months over an average of five years. The tests measured thinking and memory skills, including global cognition, processing speed, executive function, language and visual perception.
Overall, the researchers found that people with high blood pressure during pregnancy had a greater decline than those without high blood pressure during pregnancy and those who did not give birth on tests of global cognition, attention, executive function and language.
After adjusting for age and education, the mean composite score on all memory and thinking tests of participants with any type of high blood pressure disorder decreased by 0.3 points from those who did not have high blood pressure during pregnancy with a drop of 0.05. points.
Looking at different types of high blood pressure disorders, people with preeclampsia had a 0.04 point drop compared to those with other blood pressure disorders and those without blood pressure disorders, who had both a drop of 0.05.
After adjusting for age and education, people with high blood pressure during pregnancy decreased by 0.4 standard deviations over five years on tests of executive function and attention, compared with to those who had normal blood pressure for all pregnancies and only decreased by 0.1 standard deviation.
These results were more pronounced for those with preeclampsia, with a standard deviation decrease of 0.5 on tests of executive function and attention compared to a decrease of 0.1 for those with preeclampsia. normal blood pressure for all pregnancies.
“More research is needed to confirm our findings. However, these findings suggest that managing and monitoring blood pressure during and after pregnancy is an important factor for brain health later in life,” Mielke said.
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Original research: The findings will appear in Neurology