PMID- 28701338
OWN - NLM
STAT- MEDLINE
DCOM- 20170804
LR  - 20181113
IS  - 1756-1833 (Electronic)
IS  - 0959-8138 (Linking)
VI  - 358
DP  - 2017 Jul 12
TI  - Lifestyle in progression from hypertensive disorders of pregnancy to chronic
      hypertension in Nurses' Health Study II: observational cohort study.
PG  - j3024
LID - 10.1136/bmj.j3024 [doi]
AB  - Objectives To study the association between lifestyle risk factors and chronic
      hypertension by history of hypertensive disorders of pregnancy (HDP: gestational 
      hypertension and pre-eclampsia) and investigate the extent to which these risk
      factors modify the association between HDP and chronic hypertension.Design
      Prospective cohort study.Setting Nurses' Health Study II (1991-2013).Participants
      54 588 parous women aged 32 to 59 years with data on reproductive history and
      without previous chronic hypertension, stroke, or myocardial infarction.Main
      outcome measure Chronic hypertension diagnosed by a physician and indicated
      through nurse participant self report. Multivariable Cox proportional hazards
      models were used to investigate the development of chronic hypertension
      contingent on history of HDP and four lifestyle risk factors: post-pregnancy body
      mass index, physical activity, adherence to the Dietary Approaches to Stop
      Hypertension (DASH) diet, and dietary sodium/potassium intake. Potential effect
      modification (interaction) between each lifestyle factor and previous HDP was
      evaluated with the relative excess risk due to interaction.Results 10% (n=5520)
      of women had a history of HDP at baseline. 13 971 cases of chronic hypertension
      occurred during 689 988 person years of follow-up. Being overweight or obese was 
      the only lifestyle factor consistently associated with higher risk of chronic
      hypertension. Higher body mass index, in particular, also increased the risk of
      chronic hypertension associated with history of HDP (relative excess risk due to 
      interaction P<0.01 for all age strata). For example, in women aged 40-49 years
      with previous HDP and obesity class I (body mass index 30.0-34.9), 25% (95%
      confidence interval 12% to 37%) of the risk of chronic hypertension was
      attributable to a potential effect of obesity that was specific to women with
      previous HDP. There was no clear evidence of effect modification by physical
      activity, DASH diet, or sodium/potassium intake on the association between HDP
      and chronic hypertension.Conclusion This study suggests that the risk of chronic 
      hypertension after HDP might be markedly reduced by adherence to a beneficial
      lifestyle. Compared with women without a history of HDP, keeping a healthy weight
      seems to be especially important with such a history.
FAU - Timpka, Simon
AU  - Timpka S
AD  - Connors Center for Women's Health and Gender Biology, Brigham and Women's
      Hospital, Boston, MA, USA.
AD  - Harvard Medical School, Boston, MA, USA.
AD  - Lund University Diabetes Center, Department of Clinical Sciences Malmo, Lund
      University, Malmo, Sweden.
FAU - Stuart, Jennifer J
AU  - Stuart JJ
AD  - Connors Center for Women's Health and Gender Biology, Brigham and Women's
      Hospital, Boston, MA, USA.
AD  - Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston,
      MA, USA.
FAU - Tanz, Lauren J
AU  - Tanz LJ
AD  - Connors Center for Women's Health and Gender Biology, Brigham and Women's
      Hospital, Boston, MA, USA.
AD  - Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston,
      MA, USA.
FAU - Rimm, Eric B
AU  - Rimm EB
AD  - Harvard Medical School, Boston, MA, USA.
AD  - Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston,
      MA, USA.
AD  - Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA,
      USA.
AD  - Channing Division of Network Medicine, Department of Medicine, Brigham and
      Women's Hospital, Boston, MA, USA.
FAU - Franks, Paul W
AU  - Franks PW
AD  - Lund University Diabetes Center, Department of Clinical Sciences Malmo, Lund
      University, Malmo, Sweden.
AD  - Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA,
      USA.
FAU - Rich-Edwards, Janet W
AU  - Rich-Edwards JW
AD  - Connors Center for Women's Health and Gender Biology, Brigham and Women's
      Hospital, Boston, MA, USA.
AD  - Harvard Medical School, Boston, MA, USA.
AD  - Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston,
      MA, USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20170712
PL  - England
TA  - BMJ
JT  - BMJ (Clinical research ed.)
JID - 8900488
SB  - AIM
SB  - IM
CIN - BMJ. 2017 Jul 13;358:j3245. PMID: 28705906
MH  - Adult
MH  - Body Mass Index
MH  - Chronic Disease/epidemiology
MH  - Cohort Studies
MH  - Diet/statistics & numerical data
MH  - *Disease Progression
MH  - Female
MH  - *Health Surveys
MH  - Humans
MH  - Hypertension/*epidemiology
MH  - Hypertension, Pregnancy-Induced/*epidemiology
MH  - *Life Style
MH  - Middle Aged
MH  - *Nurses
MH  - Obesity/epidemiology
MH  - Overweight/epidemiology
MH  - Pre-Eclampsia/*epidemiology
MH  - Pregnancy
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Risk Reduction Behavior
MH  - United States/epidemiology
MH  - *Women's Health
PMC - PMC5506852
COIS- Competing interests: All authors have completed the ICMJE uniform disclosure form
      at www.icmje.org/coi_disclosure.pdf and declare: no support from any organization
      for the submitted work; no financial relationships with any organizations that
      might have an interest in the submitted work in the previous three years; no
      other relationships or activities that could appear to have influenced the
      submitted work.
EDAT- 2017/07/14 06:00
MHDA- 2017/08/05 06:00
CRDT- 2017/07/14 06:00
PHST- 2017/07/14 06:00 [entrez]
PHST- 2017/07/14 06:00 [pubmed]
PHST- 2017/08/05 06:00 [medline]
AID - 10.1136/bmj.j3024 [doi]
PST - epublish
SO  - BMJ. 2017 Jul 12;358:j3024. doi: 10.1136/bmj.j3024.