Why the study?
Racial disparities in incident hypertension and hypertension-related cardiovascular outcomes are significant, but the role of adverse pregnancy outcomes as mediators is not well defined.
To what extent do adverse pregnancy outcomes (such as hypertensive disorders of pregnancy) mediate the Black-White racial disparity in incident hypertension 2 to 7 years after delivery?
Cohort (n=3,335)
Yes
To what extent do adverse pregnancy outcomes (such as hypertensive disorders of pregnancy) mediate the Black-White racial disparity in incident hypertension 2 to 7 years after delivery?
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“We didn't expect to see such a dramatic increase. Since hypertension is a leading risk factor for coronary heart disease—for which death rates have improved—I thought we'd see an improvement in hypertension in conjunction with that overall trend. But we're just seeing it get worse and worse.”
“Our results provide additional insight into the prior observation that the overall rate of decline of cardiovascular disease mortality has slowed and heart failure-related cardiovascular disease deaths are now rising.”
Adverse pregnancy outcomes account for nearly one-fifth of the racial disparities observed in incident hypertension years after delivery, indicating that pre- and intra-pregnancy cardiovascular health optimization are critical targets for reducing long-term inequities.
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Nambiar et al. (2020) conducted a cohort in Incident hypertension postpartum (n=3,335). Non-Hispanic Black race and ethnicity vs. Non-Hispanic White race and ethnicity was evaluated on Incident hypertension at the follow-up visit (2 to 7 years postpartum) (RD 107.1 per 1000 births, 95% CI 69.6-144.4, p=<0.01).
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