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Hypertension. 2016 Jan;67(1):223-8. doi: 10.1161/HYPERTENSIONAHA.115.06360. Epub 2015 Nov 16.

Hypertension Risk Subsequent to Gestational Dysglycemia Is Modified by Race/Ethnicity.

Author information

1
From the Medicine/Diabetes Unit (R.B.-L., J.H., S.L.) and Medicine/Division of Nephrology (J.W., R.T.), Massachusetts General Hospital, Boston. rbentleylewis@mgh.harvard.edu.
2
From the Medicine/Diabetes Unit (R.B.-L., J.H., S.L.) and Medicine/Division of Nephrology (J.W., R.T.), Massachusetts General Hospital, Boston.

Abstract

Gestational diabetes mellitus is associated with an increased risk of type 2 diabetes mellitus and hypertension. Additionally, gestational dysglycemia has been associated with an increased risk of type 2 diabetes mellitus but not yet associated with hypertension subsequent to pregnancy in long-term follow-up. Therefore, we set out to examine this relationship as well as the role of race/ethnicity in modifying this relationship. We analyzed a prospective observational cohort followed between 1998 and 2007. There were 17 655 women with self-reported race/ethnicity and full-term, live births. A 1-hour 50 g oral glucose-load test and a 3-hour 100 g oral glucose-tolerance test enabled third trimester stratification of women into 1 of 4 glucose-tolerance groups: (1) normal (n=15 056); (2) abnormal glucose-load test (n=1558); (3) abnormal glucose-load and -tolerance tests (n=520); and (4) gestational diabetes mellitus (n=521). Women were then followed for a mean±standard deviation of 4.1±2.9 years after delivery for the development of hypertension. Although gestational diabetes mellitus was associated with an increased risk of hypertension after pregnancy (odds ratio [95% confidence interval]: 1.58 [1.02, 2.45]; P=0.04), dysglycemia defined by an abnormal glucose-load test predicted hypertension only among black women (4.52 [1.24, 16.52]; P=0.02). The risk of hypertension after pregnancy among dysglycemia groups not meeting criteria for gestational diabetes mellitus varied based on the race/ethnicity of the population. Further research on the implications of the intersection of race/ethnicity and gestational dysglycemia on subsequent hypertension is warranted.

KEYWORDS:

diabetes mellitus; ethnic groups; gestational; glucose intolerance; hypertension; pregnancy

PMID:
26573715
PMCID:
PMC4827775
DOI:
10.1161/HYPERTENSIONAHA.115.06360
[Indexed for MEDLINE]
Free PMC Article

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