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Hypertensive disorders of pregnancy (HDP) are associated with adverse maternal and fetal outcomes during pregnancy and long-term cardiovascular morbidity in mothers. Currently, data on HDP burden in subgroups of Asian and Hispanic women are lacking.
Using U.S. live births data, researchers determined rates of new-onset HDP among more than 13 million women self-identifying as Hispanic/Latina or Asian or Pacific Islander who had a singleton first live birth between 2011 and 2019. Their mean age was 26 years. Non-Hispanic Asian or Pacific Islander subgroups included Asian Indian, Chinese, Filipina, Japanese, Korean, and Vietnamese, and Hispanic/Latina subgroups included Central or South American, Cuban, Mexican, and Puerto Rican. Results included the following:
From 2011 to 2019, the HDP rate increased overall from 57.2 per 1000 live births to 99.7 per 1000 live births.
In 2019, the highest HDP prevalence among non-Hispanic Asian or Pacific Islander subgroups was in Filipina women (92.5/1000 live births); among Hispanic/Latina subgroups, Puerto Rican women had the highest HDP rate (98.6/1000).
Significant heterogeneity in HDP prevalence was observed across subgroups throughout the study period.
Shah NS et al. Trends in de novo hypertensive disorders of pregnancy among Asian and Hispanic population subgroups in the United States, 2011 to 2019. JAMA Cardiol 2022 Jun 8; [e-pub]. (https://doi.org/10.1001/jamacardio.2022.1378)
Comment
These data highlight the importance of disaggregating race-ethnicity groups in order to identify true risk profiles among patients. They also illustrate the ongoing rise in HDP in our society. The recent Chronic Hypertension and Pregnancy (CHAP) trial in pregnant women with mild chronic hypertension showed that targeting a blood pressure of less than 140/90 mm Hg was associated with better maternal and fetal outcomes (NEJM JW Gen Med May 2022 and N Engl J Med 2022; 386:1781), which supports a strategy of finding and treating HDP, especially in vulnerable subgroups.