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Hypertensive disorders of pregnancy and the risk of dementia: a systematic review and meta-analysis of cohort studies

Hypertension Research volume 47, pages 859–866 (2024)Cite this article

A Comment to this article was published on 09 February 2024

Abstract

This study aimed to investigate the association between hypertensive disorders of pregnancy (HDP) and subsequent risk of dementia using a systematic review and meta-analysis of cohort studies. We searched PubMed and Scopus for eligible studies that investigated the association between HDP and dementia risk. Using the random-effects model, pooled hazard ratio (HR) and 95% confidence interval (CI) of dementia risk in women with HDP were calculated. We applied the I2 statistic to measure heterogeneity across studies and the test for funnel plot asymmetry to evaluate publication bias. Six cohort studies were eligible: three from the United States, two from Sweden, and one from Denmark. When combined, HDP was associated with the risk of dementia: pooled HR (95% CI) = 1.31 (1.12, 1.53). The heterogeneity across studies was moderate (I2 = 47.3%, p-heterogeneity = 0.091), but no signs of publication bias were detected. The association of HDP with vascular dementia was stronger than that with Alzheimer’s disease: pooled HRs (95% CIs) = 1.66 (1.13, 2.43) and 1.29 (0.97, 1.72), respectively. In conclusion, HDP was associated with a higher risk of dementia and this association was more prominent with vascular dementia.

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All data generated or analyzed during this study were included in this published article.

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Funding

This study was supported by the Intramural Research Fund (20-4-9) for the cardiovascular diseases of the National Cerebral and Cardiovascular Center, the JST Grant Number JPMJPF2018, and the Japan Agency for Medical Research and Development (dk0207025).

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Authors and Affiliations

  1. Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan

    Ahmed Arafa, Rena Kashima, Keiko Shimamoto, Haruna Kawachi, Masayuki Teramoto, Yukie Sakai, Qi Gao, Chisa Matsumoto & Yoshihiro Kokubo

  2. Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

    Ahmed Arafa

  3. Department of Cardiovascular Pathophysiology and Therapeutics, Graduate School of Medicine, Osaka University, Suita, Japan

    Rena Kashima

  4. Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan

    Keiko Shimamoto

  5. Department of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Suita, Japan

    Haruna Kawachi

  6. Department of Cardiology, Center for Health Surveillance and Preventive Medicine, Tokyo Medical University Hospital, Shinjuku, Japan

    Chisa Matsumoto

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  1. Ahmed Arafa
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  2. Rena Kashima
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Contributions

All authors made a substantial contribution to this work. Conceptualization (AA and YK), data collection (AA and MT), analysis and manuscript writing (AA), resources (YK), and revision and editing (AA, RK, MT, YS, SN, KS, HK, QG, CM, and YK).

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Correspondence to Ahmed Arafa.

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Arafa, A., Kashima, R., Shimamoto, K. et al. Hypertensive disorders of pregnancy and the risk of dementia: a systematic review and meta-analysis of cohort studies. Hypertens Res 47, 859–866 (2024). https://doi.org/10.1038/s41440-023-01520-7

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