Hypertensive disorders of pregnancy linked to dementia

Individuals with hypertensive disorders of pregnancy (HDP) may be at increased risk of dementia, as suggested in a retrospective cohort study.

Researchers used data from the Korean National Health Insurance Service database. They identified 1,370,485 females (mean age 29.2 years) who had a childbirth, of whom 28,747 (2.1 percent) experienced HDP. HDP included gestational hypertension, pre-eclampsia, HELLP (haemolysis, elevated liver enzymes, low platelet count) syndrome, and eclampsia.

The cumulative incidence of dementia, including Alzheimer’s disease and vascular dementia, was significantly higher in the HDP group than in the no-HDP control group, at 7.2 vs 2.8 per 10,000 females (p<0.001). The corresponding incidence density of dementia was 3 vs 1.05 per 100,000 person-years (p<0.001).

HDP was associated with a 96-percent increased dementia risk in a Cox proportional hazards regression model adjusted for baseline maternal, socioeconomic, and obstetric factors (adjusted hazard ratio [HR], 1.96, 95 percent CI, 1.19–3.23). The risk was attenuated and no longer significant following further adjustment for postdelivery hypertension, diabetes, myocardial infarction, and stroke (adjusted HR, 1.15, 95 percent CI, 0.70–1.91).

The findings suggest that HDP may serve as an early-life marker of long-term neurovascular vulnerability. However, the researchers advised careful interpretation of the findings due to the small number of dementia events among females with HDP.