title: Hypertension Risk Subsequent to Gestational Dysglycemia Is Modified by Race/Ethnicity.
abstract: Gestational diabetes mellitus is associated with an increased risk of type 2 diabetes mellitus and hypertension. Additionally, gestational dysglycemia has been associated with an increased risk of type 2 diabetes mellitus but not yet associated with hypertension subsequent to pregnancy in long-term follow-up. Therefore, we set out to examine this relationship as well as the role of race/ethnicity in modifying this relationship. We analyzed a prospective observational cohort followed between 1998 and 2007. There were 17 655 women with self-reported race/ethnicity and full-term, live births. A 1-hour 50 g oral glucose-load test and a 3-hour 100 g oral glucose-tolerance test enabled third trimester stratification of women into 1 of 4 glucose-tolerance groups: (1) normal (n=15 056); (2) abnormal glucose-load test (n=1558); (3) abnormal glucose-load and -tolerance tests (n=520); and (4) gestational diabetes mellitus (n=521). Women were then followed for a mean±standard deviation of 4.1±2.9 years after delivery for the development of hypertension. Although gestational diabetes mellitus was associated with an increased risk of hypertension after pregnancy (odds ratio [95% confidence interval]: 1.58 [1.02, 2.45]; P=0.04), dysglycemia defined by an abnormal glucose-load test predicted hypertension only among black women (4.52 [1.24, 16.52]; P=0.02). The risk of hypertension after pregnancy among dysglycemia groups not meeting criteria for gestational diabetes mellitus varied based on the race/ethnicity of the population. Further research on the implications of the intersection of race/ethnicity and gestational dysglycemia on subsequent hypertension is warranted.
authors.affiliation: From the Medicine/Diabetes Unit (R.B.-L., J.H., S.L.) and Medicine/Division of Nephrology (J.W., R.T.), Massachusetts General Hospital, Boston. rbentleylewis@mgh.harvard.edu.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Bentley-Lewis
authors.affiliation: From the Medicine/Diabetes Unit (R.B.-L., J.H., S.L.) and Medicine/Division of Nephrology (J.W., R.T.), Massachusetts General Hospital, Boston.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Huynh
authors.affiliation: From the Medicine/Diabetes Unit (R.B.-L., J.H., S.L.) and Medicine/Division of Nephrology (J.W., R.T.), Massachusetts General Hospital, Boston.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Li
authors.affiliation: From the Medicine/Diabetes Unit (R.B.-L., J.H., S.L.) and Medicine/Division of Nephrology (J.W., R.T.), Massachusetts General Hospital, Boston.
authors.forename: Julia
authors.initials: J
authors.lastname: Wenger
authors.affiliation: From the Medicine/Diabetes Unit (R.B.-L., J.H., S.L.) and Medicine/Division of Nephrology (J.W., R.T.), Massachusetts General Hospital, Boston.
authors.forename: Ravi
authors.initials: R
authors.lastname: Thadhani
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D016640:Diabetes, Gestational / Q000097:blood / Q000208:ethnology*; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000097:blood / Q000208:ethnology*; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology; D008404:Massachusetts / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D015995:Prevalence; D011446:Prospective Studies; D044469:Racial Groups; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
keywords: diabetes mellitus; ethnic groups; gestational; glucose intolerance; hypertension; pregnancy