Gestational hypertension may be linked to cerebral small vessel disease

Midlife women with a history of gestational hypertension exhibit some signs of cerebral small vessel disease, according to a study.

The study included 538 women who were followed from early pregnancy. Of these, 445 (82.5 percent) had normotensive index pregnancies, and the remaining 93 (17.2 percent) had hypertensive disorders in the index pregnancy.

Over a median of 14.6 years after the index pregnancy, women underwent magnetic resonance imaging to assess brain tissue and white matter hyperintensity volume, lacunar infarcts, and cerebral microhaemorrhages as markers of cerebral small vessel disease.

Compared with women who had previous normotensive pregnancy, those who had prior hypertensive disorders of pregnancy had increased white matter hyperintensity volume (adjusted β, 0.32, 95 percent confidence interval [CI], 0.08–0.56).

The association was primarily observed in women with gestational hypertension, who exhibited a greater volume of white matter hyperintensities than those with prior normotensive pregnancies (adjusted β, 0.39, 95 percent CI, 0.10–0.67). Furthermore, the effect was larger in those with gestational hypertension who developed chronic hypertension after the index pregnancy.

No significant differences were seen in infarcts or cerebral microhaemorrhages.

The findings provide further evidence for the epidemiological connection between long-term cerebrovascular risk and both pre-eclampsia and gestational hypertension.