Gen Z and Millennials are twice as likely to develop high blood pressure during pregnancy
Higher rates of hypertension persist even after adjusting for gestational age differences.
- High blood pressure during pregnancy increases and is one of the main causes of maternal mortality
- High blood pressure in pregnancy is associated with an increased risk of heart failure and stroke in the mother and premature birth or death in the baby
- Pregnant Alaskan Indians and non-Hispanic blacks are most affected
Gen Zers and Millennials are about twice as likely to be diagnosed with high blood pressure during pregnancy, including preeclampsia and gestational hypertension, compared to Baby Boomers. This is true even after adjusting for age differences in pregnancy, reports a new Northwestern Medicine study.
This discovery is significant because it is widely believed that the rise in high blood pressure during pregnancy is due to people becoming pregnant at an older age. However, this research provides new evidence that high blood pressure rates during pregnancy are higher in individuals of younger generations, regardless of their age.
“Although there are many reasons for the observed generational alternations, we believe that in large part this is due to the observed generational decline in heart health,” said study author Dr. Sadiya Khan. She is an assistant professor of medicine Northwest University Feinberg School of Medicine and a Northwestern Medicine Physician. “We’re seeing more and more people in younger generations entering pregnancy with risk factors like obesity.”
Khan said the stakes are high.
“High blood pressure during pregnancy is a leading cause of death for both mothers and babies,” Khan said. “High blood pressure during pregnancy is associated with an increased risk of heart failure and stroke in the mother and an increased risk of preterm birth, stunted growth, or death of the baby.”
The study was published in August 24, 2020 Open JAMA network.
Previous research from Northwestern and the Centers for Disease Control and Prevention (CDC) has highlighted the nearly doubling of rates of high blood pressure in pregnancy over the past decade.
In fact, more than a million millennials have been diagnosed with high blood pressure during their first pregnancy, according to Khan. Racial and ethnic disparities also persisted in the four generations studied. According to the new Northwestern study, the highest rates of high blood pressure during pregnancy were among those who identified as non-Hispanic Native American/Alaskan and non-Hispanic Black.
“This is the first cross-generational study to go beyond maternal age or calendar year of delivery to understand patterns of hypertension in pregnancy,” Khan said. “This is particularly important when we consider the legacy of significant racial and ethnic differences in this high-risk disease, which affects not only the mother but also the baby.” This sets in motion a vicious cycle of generational health degradation by starting life with poorer heart health.”
“The public health and clinical message of this work is the need to broaden our perspective on screening and broaden our focus on prevention in all age groups before and during pregnancy, especially younger people who are not traditionally considered to be at high risk.” ‘ said study lead author Dr. Natalie Cameron. She is a Medical Instructor at Feinberg and a Physician for Northwestern Medicine.
Khan said that mobile health technologies (e.g. wearable devices) and telemedicine/remote health have opened up opportunities to improve blood pressure monitoring in an equitable way.
“Prevention and earlier detection can save lives and improve the health of future generations from birth,” Khan said.
The study was conducted using data from the National Vital Statistics System Natality Database, which contains birth certificate information for all live births in the United States. The study focused on people’s first pregnancies between 1995 and 2019 and included data from more than 38 million people. Using this data, the researchers were able to determine rates of hypertensive pregnancy disorders grouped by mother’s year of birth (maternal birth cohort) and her 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, August 24, 2022, JAMA network open.
Other Northwestern authors include Lucia C. Petito, Dr. Nilay S Shah, Dr. Amanda M Perak, Dr. Donald M. Lloyd Jones and Dr. Phillip Greenland.
This research was supported by grant 1R01HL161514 from the National Heart, Lung, and Blood Institute of the National Institutes of Health.