Un nuevo estudio de Northwestern Medicine encuentra que los Gen Zers y los millennials tienen aproximadamente dos veces más probabilidades de que se les diagnostique presión arterial alta durante el embarazo.
Las tasas más altas de presión arterial alta persisten incluso después de ajustar las diferencias de edad en el embarazo.
- La presión arterial alta en el embarazo está aumentando y es una de las principales causas de muerte materna
- La hipertensión en el embarazo está relacionada con un mayor riesgo de insuficiencia cardíaca y accidente cerebrovascular en la madre, y de que el bebé sea prematuro o muera
- Las personas embarazadas indias americanas/nativas de Alaska y negras no hispanas son las más afectadas
La generación Z y la generación del milenio tienen aproximadamente dos veces más probabilidades de que se les diagnostique presión arterial alta durante el embarazo, lo que incluye preeclampsia e hipertensión gestacional, en comparación con las personas embarazadas de la generación del baby boom. Esto es cierto incluso después de ajustar las diferencias de edad en el embarazo, informa un nuevo estudio de Northwestern Medicine.
Este descubrimiento es significativo porque comúnmente se cree que los aumentos en las tasas de presión arterial alta durante el embarazo se deben a que las personas quedan embarazadas a edades más avanzadas. Sin embargo, esta investigación descubrió recientemente que las tasas de presión arterial alta durante el embarazo son más altas entre las personas de generaciones más recientes, independientemente de su edad durante el embarazo.
“Si bien hay muchas razones para los cambios generacionales observados, suponemos que esto se debe, en gran parte, al deterioro generacional observado en la salud del corazón”, dijo la autora correspondiente del estudio, la Dra. Sadiya Khan. Es profesora asistente de medicina en[{” attribute=””>Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician. “We are seeing more people in more recent generations entering pregnancy with risk factors such as obesity.”
Khan said that the stakes are high.
“High blood pressure during pregnancy is a leading cause of death for both mom and baby,” Khan said. “High blood pressure during pregnancy is associated with increased risk of heart failure and stroke in the mother and increased risk of the baby being born prematurely, being growth restricted or dying.”
The study was published on August 24, 2020, in JAMA Open Network.
Previous research from Northwestern and the Centers for Disease Control and Prevention (CDC) has highlighted the near doubling in rates of hypertension in pregnancy over the past decade.
In fact, more than a million millennials have already been diagnosed with high blood pressure during their first pregnancies, according to Khan. In the four generations studied, racial and ethnic disparities have also persisted. According to the new Northwestern study, the highest rates of high blood pressure during pregnancy were among those who identified as non-Hispanic American Indian/Alaskan Native and non-Hispanic Black.
“This is the first multi-generational study that moves beyond the age of the mom or the calendar year of the delivery to understand patterns of hypertension in pregnancy,” Khan said. “This is especially important when we look at the legacy of substantial racial and ethnic disparities in this high-risk condition that affects not only the mom but also the baby. This sets up a vicious cycle of generational health decline by starting life with poorer heart health.”
“The public health and clinical message from this work is the need to broaden our perspective on screening and expand our focus on prevention in all age groups before and during pregnancy, particularly among younger people who have traditionally not been considered at high risk,” said study first author Dr. Natalie Cameron. She is an instructor of medicine at Feinberg and a Northwestern Medicine physician.
Khan said mobile health technologies (e.g., wearable devices) and telehealth/remote health opportunities have opened opportunities to equitably improve surveillance for blood pressure.
“Prevention and earlier identification can be life-saving and improve the health of future generations beginning at birth,” Khan said.
The study was conducted using data from the National Vital Statistics System Natality Database, which contains information from birth certificates for all live births in the United States. The study focused on first pregnancies of individuals between 1995-2019 and included data from more than 38 million people. Using these data, investigators were able to determine rates of hypertensive disorders of pregnancy grouped by the mother’s birth year (maternal birth cohort) and their self-identified race or ethnicity.
Reference: “Association of Birth Year of Pregnant Individuals With Trends in Hypertensive Disorders of Pregnancy in the United States, 1995-2019” by Natalie A. Cameron, MD; Lucia C. Petito, PhD; Nilay S. Shah, MD, MPH; Amanda M. Perak, MD, MS; Janet M. Catov, PhD, MS; Natalie A. Bello, MD, MPH; Simon Capewell, DSc, MD; Martin O’Flaherty, MD, MSc, PhD; Donald M. Lloyd-Jones, MD, ScM; Philip Greenland, MD; William A. Grobman, MD, MBA and Sadiya S. Khan, MD, MS, 24 August 2022, JAMA Network Open.
DOI: 10.1001/jamanetworkopen.2022.28093
Other Northwestern authors include Lucia C. Petito, Dr. Nilay S. Shah, Dr. Amanda M. Perak, Dr. Donald M. Lloyd-Jones, and Dr. Philip Greenland.
This research was supported by grant 1R01HL161514 from the National Heart, Lung, and Blood Institute of the National Institutes of Health.
