Hypertensive pregnancy disorders associated with worse neurological outcomes

Hypertensive pregnancy disorders were associated with smaller brain volume and slower cognitive performances, according to research presented at the American Academy of Neurology annual meeting.

The disorders may contribute to an increased risk for cognitive decline and dementia, Michelle Mielke, PhD, a researcher at the Mayo Clinic, and colleagues wrote.

"Previous studies suggest hypertensive pregnancy disorders are associated with subjective cognitive complaints or brain white matter lesions 5 to 10 years after the hypertensive pregnancy," Mielke and colleagues wrote in their abstract. "The long-term effects of hypertensive pregnancies on brain structure and cognitive function remain unknown."

Michelle Mielke

The researchers evaluated data from 1,167 women who participated in the Family Blood Pressure Project Genetic Epidemiology Network of Arteriopathy study. Participants indicated hypertensive pregnancy disorders via a questionnaire and underwent a neurocognitive battery and MRI.

Results showed that women who reported a history of hypertensive pregnancy disorders had worse performances on processing speed tests: Stroop (mean score = 173.9 vs. 181; P = .002), Trail Making Test Part A (mean seconds = 45.1 vs. 42.2; P = .035) and Digit Symbol Substitution Test (mean score = 41.2 vs. 43.4; P = .005). In addition, they had smaller brain volumes when compared with women who indicated a history of normotensive pregnancy (286 vs. 297; P = .023).

Mielke and colleagues concluded that hypertensive pregnancy disorders were associated with poorer processing speed test performance and smaller brain volumes decades after the disorders. They wrote that population-based studies would help provide critical insight into risks for dementia and cognitive decline.

"In our multiethnic study of women, we found that a history of hypertensive pregnancies was associated with poorer cognitive performance, especially in processing speed, and greater brain atrophy decades later in a relatively young group of women (mean age of 61)," Mielke told Healio Internal Medicine. "[Hypertensive pregnancies] have been identified as a risk factor by the AHA guidelines for prevention of cardiovascular disease and stroke in women. Our results suggest that women with a history of [hypertensive pregnancies] should be closely monitored for signs and symptoms of cognitive decline and that their modifiable vascular risk factors need to be monitored and treated adequately." – by Chelsea Frajerman Pardes

Reference:

Mielke M, et al. Cognition and Brain Atrophy Decades after Hypertensive Pregnancy Disorders. Presented at: American Academy of Neurology Annual Meeting; April 15-21, 2016; Vancouver, British Columbia.

Disclosures: Mielke received consulting fees from Lysosomal Therapeutics, Inc. Please see the full abstract for a complete list of all other authors' relevant financial disclosures.