Recent research published in the journal Alzheimer’s & Dementia sheds light on a potential link between common pregnancy-related conditions, hypertensive disorders of pregnancy (HDP), and the risk of dementia in women.
80‐Year Retrospective Study Reveals Link between Hypertensive Disorders of Pregnancy and Risk of Dementia
Department Contributors: Jennifer Majersik and Norman Foster
Alzheimer's disease and related dementias (ADRD) have emerged as significant health challenges in our aging population. What's even more concerning is that studies have consistently shown that women bear a disproportionate burden when it comes to these cognitive disorders. A Framingham Heart Study revealed that the lifetime risk of developing these conditions after the age of 45 is one in five for women, while it's one in ten for men. This gender disparity in dementia risk cannot be solely attributed to women's longer lifespan, suggesting that there might be other factors at play.
Recent research published in the journal Alzheimer’s & Dementia involved two of our faculty members, Jennifer Majersik, MD, MS, chair of our Vascular Division, and Professor Emeritus Norman Foster, MD. This study sheds light on a potential link between common pregnancy-related conditions, hypertensive disorders of pregnancy (HDP), and the risk of dementia in women.
What is HDP?
HDP includes preeclampsia, eclampsia, gestational hypertension, and chronic hypertension with superimposed preeclampsia or eclampsia. These conditions alter blood vessel function and affect 3% to 8% of pregnancies. HDP is estimated to impact approximately one in seven women during their reproductive years. There has been a recent rise in the prevalence of HDP over the past five years, making it a significant concern in women's reproductive health. Too often recognition of HDP is delayed and not aggressively treated. Just this year, routine screening for all forms of HDP was recommended by the US Preventative Services Task Force, reflecting the increasing attention needed to these conditions.
HDP is not to be taken lightly—it is the leading cause of maternal and perinatal morbidity and mortality. And while HDP primarily affects pregnant women, the latest research findings suggest that its impact might extend beyond pregnancy. Uncontrolled high blood pressure and vascular disease increase the risk of dementia. Stroke, caused by damaged blood vessels and heart disease, often leads to vascular dementia. Blood vessel injury is believed to be less a factor in Alzheimer’s disease. Usually, risks factors only are assessed in middle age or older individuals. Because all forms of HDP affect the vascular system, investigators wanted to know whether blood vessel disease early in life might increase the risk of future dementia.
The Study's Findings
In this study, Dr. Majersik, Dr. Foster, and a team of multidisciplinary researchers led by Dr. Karen Schliep in the Division of Public Health at the University of Utah examined the health records of over 59,000 women with and without HDP during pregnancy. This 80-year retrospective study utilized data from the Utah Population Database, allowing long-term health outcomes to be analyzed. The results were significant: women who had experienced HDP had a 1.37 times higher risk of all-cause dementia. The risk was even more pronounced for vascular dementia, with a 1.64 times higher likelihood, and other dementias, with a 1.49 times higher risk. The risk of Alzheimer’s disease, the most common cause of dementia, was not increased.
These findings highlight the importance of understanding the long-term consequences of pregnancy-related conditions like HDP. While pregnancy is a natural and beautiful part of life, it's essential to recognize that it can have lasting effects on a woman's health, potentially increasing the risk of dementia in later years. The research underlines the importance of early recognition and treatment of HDP. It also provides further evidence that addressing medical problems early in life can affect the risk of late life brain diseases.
What's Next?
Further research is needed to delve into the mechanisms behind this association and to develop strategies for early intervention and prevention. As we continue to unravel the mysteries of dementia, it's imperative that we consider the unique life course experiences of women and the potential impact of conditions like HDP on their cognitive health.
The link between HDP and the heightened risk of dementia in women is a significant discovery in the field of women's health and cognitive science. This research underscores the value of a holistic and multidisciplinary approach to understanding and addressing dementia, taking into account not only genetic factors and aging but also the unique experiences and challenges that women face throughout their lives.
