Hypertensive Disorders of Pregnancy Rise in US, Especially in Asians and Hispanics

By Shawana Alleyne-Morris

June 29, 2022

NEW YORK (Reuters Health) - De novo hypertensive disorders of pregnancy (HDP) are on the rise in the U.S. in all major racial and ethnic groups and subgroups, but with significant heterogeneity, researchers said.

The largest rate increases have occurred in Asian and Hispanic/Latinx populations, the researchers found.

Dr. Nilay S. Shah of Northwestern University Feinberg School of Medicine in Chicago and colleagues analyzed patterns of preeclampsia and gestational hypertension from 2011 through 2019 in 13.2 million individuals ages 15 to 44, using the U.S. National Center for Health Statistics natality database.

As reported in JAMA Cardiology, 55.9% of study subjects were non-Hispanic white, 20.6% were Hispanic/Latina (Central and South American, Cuban, Mexican, Puerto Rican), 14.1% were non-Hispanic Black, and 7.8% were non-Hispanic Asian or Pacific Islander (Asian Indian, Chinese, Filipina, Japanese, Korean, or Vietnamese).

Overall, HDP rates rose by 7.3%, from 57.2 per 1000 live births in 2011 to 99.7 per 1000 live births in 2019.

The highest mean annual percentage changes were seen among Japanese (11.3%), Chinese (10.4%), Asian Indian (10.2%), and Puerto Rican (9.5%) study subjects.

Non-Hispanic Blacks had the lowest mean annual percentage change, at 6.7%, but the highest 2019 rate, at 117.3 per 1,000 live births. The 2019 rate was 108.2 per 1,000 live births in non-Hispanic whites.

Among non-Hispanic Asians, the highest 2019 rate was in Filipina individuals, at 92.5 per 1,000 live births, and the lowest was in Chinese individuals, at 27.6 per 1,000 live births.

Among Hispanic/Latina subgroups, 2019 HDP rates ranged from 69.1 per 1,000 live births in Central/South American individuals to 98.6 per 1,000 live births in Puerto Rican individuals.

Known HDP risk factors like diabetes and obesity before pregnancy likely play a role in the rising HDP rates, the authors said.

"To reduce persistent HDP disparities by race and ethnicity and prevent consequent cardiovascular disease, culturally tailored and community-informed intervention strategies that aim to both primarily prevent HDP and to secondarily target the long-term sequelae of HDP are urgently warranted," they concluded.

SOURCE: https://bit.ly/3b50raA JAMA Cardiology, online June 8, 2022.