Maternal hypertension alone or together with hypertensive disorders of pregnancy (HDP) is associated with an elevated risk of hypertension in offspring, according to study findings presented at the American Society of Nephrology’s Kidney Week 2021. Gestational exposure to HDP alone is not associated with increased risk.

The population-based cohort study, conducted by Virginia Dines, MD, of Mayo Clinic in Rochester, Minnesota, and colleagues, included 7544 women with 9862 pregnancies and 8755 offspring who had available records after age 1 year. Of the offspring, 655 (7.5%) were exposed to HDP in gestation and 316 (3.6%) were exposed to preeclampsia (PE) or eclampsia.

Exposure to HDP, compared with no exposure, was significantly associated with a 1.5-fold increased risk for hypertension in the offspring in adjusted analyses. The study found no association between PE and hypertension in the offspring. Maternal hypertension as a time-dependent (TD) covariate was significantly associated with a 1.7-fold increased risk for hypertension in the offspring. Maternal hypertension as a TD covariate was significantly associated with a 2.3- and 1.6-fold increased risk for hypertension in the offspring among offspring exposed and not exposed to HDP in pregnancy, respectively.


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Maternal hypertension before age 55 years was significantly associated with a 1.8-fold increased risk for hypertension in the offspring. HDP exposure by itself during gestation was not significantly associated with increased risk.

Further, maternal hypertension alone before age 55 years and both maternal hypertension and HDP gestational exposure before age 55 years were significantly associated with 1.7- and 2.2-fold increased risks for hypertension in offspring compared with the absence of both factors. Maternal hypertension before age 55 years was significantly associated with 3.9- and 1.7-fold increased risks for subsequent hypertension in offspring among offspring exposed and not exposed to HDP in gestation, respectively. HDP exposure alone was not associated with increased risk of hypertension.

The finding that HDP exposure by itself was not associated with an increased risk of hypertension in offspring “suggests that the elevated risk of hypertension in offspring exposed to HDP may be due to shared risk factors, rather than a direct effect,” the authors concluded.

“Offspring who have been exposed to hypertensive disorders of pregnancy in gestation and those with maternal hypertension should be considered an elevated risk group,” they wrote.

Reference

Dines V, Kattah A, Weaver A, et al. Maternal hypertension and hypertensive disorders of pregnancy are associated with increased risk of hypertension in offspring. Presented at: Kidney Week 2021, November 2-7, 2021. Abstract PO2236.