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Chronic hypertension is associated with an 11-fold increase in the risk of preeclampsia during pregnancy

Preeclampsia is a reversible complication that occurs in about 2.5 percent of pregnancies. It is diagnosed from symptoms of hypertension, proteinuria (excessive protein in the urine), and edema (swelling) after 20 weeks of gestation. Preeclampsia can develop in both normotensive women (those with normal blood pressure) and those with preexisting chronic hypertension, and it can progress to eclampsia, that is, convulsions. Preeclampsia and eclampsia contribute to maternal death and increased risk of preterm birth, intrauterine growth retardation, and newborn deaths.

A recent study revealed that, compared with normotensive women, both black and white women who have chronic hypertension have an 11-fold higher risk of developing preeclampsia during pregnancy. Furthermore, since black women in the study had twice the rate of chronic hypertension of white women (1.5 vs. 0.7 percent, respectively), chronic hypertension intervention programs would provide significantly greater prevention benefits and a lower disease burden among black women, conclude the researchers. The study was conducted by researchers at the Program for Health Effectiveness Research, Clinical Research Center at the Morehouse School of Medicine in Atlanta, and was supported in part by the Agency for Healthcare Research and Quality (HS07400).

The researchers used hospital discharge summary records from the National Hospital Discharge Survey for 1988 to 1996 to examine the relationship between preexisting chronic hypertension and preeclampsia among 38,402 black and 144,285 white pregnant women with hospital deliveries during the study period. They found that irrespective of race, the risk of preeclampsia was greater among younger women (aged 15 to 19) than older women (aged 20 to 39) and among single women compared with married women. Women who had diabetes or a genitourinary infection also were at greater risk of preeclampsia than women who did not have these conditions.

See "Preeclampsia associated with chronic hypertension among African-American and white women," by Aziz R. Samadi, M.D., M.P.H., Robert M. Mayberry, Ph.D., and James W. Reed, M.D., in the Spring/Summer 2001 Ethnicity & Disease 11, pp. 192-200.

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