title: Hypertensive disorders in pregnancy and later dementia: a Swedish National Register Study.
abstract: BACKGROUND
  Our aim was to investigate the rate of vascular dementia and dementia in women with previous hypertensive disorders in pregnancy, since white matter lesions of the brain and cardiovascular disease are linked both to dementia and hypertensive disorders in pregnancy.
  
  
  METHODS
  Prospective population-based registry study on all women giving birth in Sweden between 1973 and 1975 (284 598). Women with and without hypertensive disorders in pregnancy were identified by means of the Swedish Medical Birth Register and linked to the National Patient Register, where data on somatic disease later in life were obtained. International classification of disease was used. The Cox proportional hazard model was used to calculate hazard ratios for both groups and adjusted for possible confounders. Main outcome measures were in-hospital diagnosis of cardiovascular disease, vascular dementia and dementia.
  
  
  RESULTS
  No increased risks were seen for vascular dementia or dementia after any hypertensive disorders in pregnancy. If broken down in specific diagnoses for hypertensive disease in pregnancy, adjusted risks for vascular dementia after hypertension and proteinuria during pregnancy the hazard ratio was 6.27 (95% CI 1.65-27.44). Higher risks for cardiovascular disease were confirmed.
  
  
  CONCLUSIONS
  Because of the very low absolute risk, the wide confidence interval and risk of misclassification, our results on vascular dementia could be questioned. Considering the pathophysiology of preeclampsia, the findings of brain lesions and the increased risk for cardiovascular disease, the possibly increased risk for all kinds of dementia must be investigated in larger and more well-defined cohorts.
authors.affiliation: Division of Obstetrics and Gynecology, Department of Clinical Sciences, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden.
authors.forename: Ellika G
authors.identifier: http://orcid.org/0000-0003-3529-9471
authors.initials: EG
authors.lastname: Andolf
authors.affiliation: Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Medicine, Linköping University, Linköping, Sweden.
authors.forename: Gunilla C M
authors.initials: GC
authors.lastname: Sydsjö
authors.affiliation: Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Medicine, Linköping University, Linköping, Sweden.
authors.forename: Marie K
authors.initials: MK
authors.lastname: Bladh
authors.affiliation: Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Medicine, Linköping University, Linköping, Sweden.
authors.forename: Goran
authors.initials: G
authors.lastname: Berg
authors.affiliation: Department of Pediatrics, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA.
authors.forename: Surendra
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D003704:Dementia / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced; D008875:Middle Aged; D011247:Pregnancy; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Alzheimer's disease; Preeclampsia; dementia; gestational hypertension; long-term consequences; posterior reversible encephalopathy syndrome; vascular dementia