Hypertensive Disorders of Pregnancy and Cardiovascular Disease Risk Across Races and Ethnicities: A Review

Abstract

Pregnancy is often considered to be a “cardiometabolic stress-test” and pregnancy complications including hypertensive disorders of pregnancy can be the first indicator of increased risk of future cardiovascular disease. Over the last two decades, more evidence on the association between hypertensive disorders of pregnancy and cardiovascular disease has become available. However, despite the importance of addressing existing racial and ethnic differences in the incidence of cardiovascular disease, most research on the role of hypertensive disorders of pregnancy is conducted in white majority populations. The fragmented knowledge prohibits evidence-based targeted prevention and intervention strategies in multi-ethnic populations and maintains the gap in health outcomes. In this review, we present an overview of the evidence on racial and ethnic differences in the occurrence of hypertensive disorders of pregnancy, as well as evidence on the association of hypertensive disorders of pregnancy with cardiovascular risk factors and cardiovascular disease across different non-White populations, aiming to advance equity in medicine.

De Novo Postpartum Hypertension: Is Pregnancy a Stress Test or Risk Factor?

“…Although prospective studies are needed to investigate the prevalence of de novo postpartum hypertension in other populations, these findings challenge the traditional views of pregnancy only as a stress-test that unmasks underlying susceptibility to hypertension. 12 The increased risk of chronic hypertension and cardiovascular morbidity following a hypertensive disorder of pregnancy have been well described. 13 Further, it is accepted that pregnancy-associated factors—such as gestational weight gain, a risk factor for obesity—may contribute to the future development of chronic hypertension.…”