Women with high blood pressure during pregnancy at greater risk for cognitive decline

Women with high blood pressure during pregnancy, particularly preeclampsia or eclampsia, experienced a greater decline in cognitive function later in life, according to findings published in Neurology.

“While high blood pressure during pregnancy, including preeclampsia, is recognized as a risk factor for heart disease and stroke, our study suggests that it may also be a risk factor for cognitive decline in later life,” Michelle M. Mielke, PhD, professor of epidemiology and prevention at Wake Forest University School of Medicine, said in a related AAN press release.

Mielke and colleagues used data from the Mayo Clinic Study of Aging to identify 2,239 women (median age, 73 years) with information on pregnancy history. Upon enrollment, women underwent interviews, physical examination and cognitive tests at study visits every 15 months. Cognitive tests assessed memory, attention and executive function, language and visuospatial perception.

The researchers categorized women as parous or nulliparous and further categorized parous women as having had all normotensive pregnancies or having a history of any hypertensive disorder of pregnancy, gestational or chronic hypertension or preeclampsia or eclampsia.

Of 1,854 (82.8%) women who had at least one pregnancy, 1,607 (86.7%) had only normotensive pregnancies, 100 (5.4%) had gestational hypertension, and 147 (7.9%) had preeclampsia or eclampsia.

Compared with parous women, nulliparous women had completed more years of education and had lower BMI and less comorbidities.

Adjusting for age and education, nulliparous women had worse global performance at baseline compared with parous women (beta = –0.2). They also performed worse on assessments of memory (b = –0.16), language (b = –0.25), attention/executive function (b = –0.13; P = .02) and visuospatial perception (b = –0.14).

Compared with women who had normotensive pregnancies, women with any hypertensive disorder of pregnancy had greater decreases in global cognition (b = –0.021) and attention/executive function (b = –0.022) over time.

When examining subtypes of hypertensive pregnancy disorders, women with preeclampsia or eclampsia had greater decreases in global cognition (b = –0.039), language (b = –0.032) and attention/executive function (b = –0.04) compared with women who had normotensive pregnancies. Differences were not significant between women with chronic or gestational hypertension and women with normotensive pregnancies.

“More research is needed to confirm our findings,” Mielke said in the release. “However, these results suggest that managing and monitoring blood pressure during and after pregnancy is an important factor for brain health later in life.”

Reference:

• High blood pressure during pregnancy linked to thinking problems later. https://www.aan.com/PressRoom/Home/PressRelease/5058. Published March 1, 2023.