Hypertension in Pregnancy and Future Cardiovascular Disease

Cardiovascular epidemiologic research historically has focused on men, because male sex is one of the major risk factors for CVD. Consequently, numerous diagnostic and treatment strategies for CVD in women have been extrapolated from results of studies conducted in men, and sex-specific factors largely have been ignored. It became apparent in the 1980s that the decrease in cardiovascular mortality in men was not accompanied by a similar decrease in women. One of the reasons for this difference might be sex-based disparities in cardiovascular care; women have been both under evaluated for CVD and under treated for modifiable risk factors for CVD. In addition, female-specific conditions, such as hypertensive disorders of pregnancy, menopause, and hormone use, might affect the onset of CVD, its clinical course, the efficacy of therapy, and, ultimately, prognosis. This proposal responds to RFA-OD-11-003 by identifying complications of hypertensive pregnancy disorders as a major biological sex difference that may influence the future cardiovascular and cognitive health of the affected women. Results of the proposed research may open new venues for the prevention, diagnosis, and treatment of CVD and cognitive impairment in women.