Hypertensive disorders of pregnancy are estimated to complicate up to 10% of pregnancies worldwide, with gestational hypertension occurring in 6% of pregnancies.[52]Umesawa M, Kobashi G. Epidemiology of hypertensive disorders in pregnancy: prevalence, risk factors, predictors and prognosis. Hypertens Res. 2017 Mar;40(3):213-20.
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[53]Yoder SR, Thornburg LL, Bisognano JD. Hypertension in pregnancy and women of childbearing age. Am J Med. 2009 Oct;122(10):890-5.
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Black and Hispanic women may have greater progression of gestational hypertension to preeclampsia/eclampsia compared with white women.[3]Ford ND, Cox S, Ko JY, et al. Hypertensive disorders in pregnancy and mortality at delivery hospitalization - United States, 2017-2019. MMWR Morb Mortal Wkly Rep. 2022 Apr 29;71(17):585-91.
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The most important factors influencing maternal and neonatal outcomes are the severity of hypertension and presence of end-organ damage, rather than excess protein excretion.[54]Fishel Bartal M, Lindheimer MD, Sibai BM. Proteinuria during pregnancy: definition, pathophysiology, methodology, and clinical significance. Am J Obstet Gynecol. 2022 Feb;226(2s):S819-34.
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Long-term disease associations
Women with hypertensive disorders of pregnancy have an increased risk of cardiovascular disease later in life. Regular assessment of cardiovascular risk in these women provides a unique opportunity for timely cardiovascular prevention.[55]Benschop L, Duvekot JJ, Roeters van Lennep JE. Future risk of cardiovascular disease risk factors and events in women after a hypertensive disorder of pregnancy. Heart. 2019 Aug;105(16):1273-8.
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[56]Wenger NK, Lloyd-Jones DM, Elkind MSV, et al; American Heart Association. Call to action for cardiovascular disease in women: epidemiology, awareness, access, and delivery of equitable health care: a presidential advisory from the American Heart Association. Circulation. 2022 Jun 7;145(23):e1059-71.
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