Hypertensive disorders of pregnancy and subsequent risk of Alzheimer's disease and other dementias

Karen C. Schliep,C. Elizabeth Shaaban, Huong Meeks,Alison Fraser, Ken R. Smith,Jennifer J. Majersik, Norman L. Foster,Jean Wactawski-Wende, Truls ostbye,JoAnn Tschanz, James F. Padbury,Surrendra Sharma, Yue Zhang, Julio C. Facelli,C. Samir Abdelrahman, Lauren Theilen,Michael W. Varner

ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING(2023)

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摘要
IntroductionWomen with hypertensive disorders of pregnancy (HDP) have an increased risk of cardiovascular disease. Whether HDP is also associated with later-life dementia has not been fully explored. MethodsUsing the Utah Population Database, we performed an 80-year retrospective cohort study of 59,668 parous women. ResultsWomen with, versus without, HDP, had a 1.37 higher risk of all-cause dementia (95% confidence interval [CI]: 1.26, 1.50) after adjustment for maternal age at index birth, birth year, and parity. HDP was associated with a 1.64 higher risk of vascular dementia (95% CI: 1.19, 2.26) and 1.49 higher risk of other dementia (95% CI: 1.34, 1.65) but not Alzheimer's disease dementia (adjusted hazard ratio = 1.04; 95% CI: 0.87, 1.24). Gestational hypertension and preeclampsia/eclampsia showed similar increased dementia risk. Nine mid-life cardiometabolic and mental health conditions explained 61% of HDP's effect on subsequent dementia risk. DiscussionImproved HDP and mid-life care could reduce the risk of dementia.
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