New research published today in the Journal of the American Heart Association reveals that the risk of pregnancy-related high blood pressure varies significantly among subgroups of Asian American, Native Hawaiian, and Pacific Islander people. The findings, based on an analysis of California health records from 2007 to 2019, highlight the need for targeted prevention and treatment approaches tailored to specific ethnic groups.
According to the study, Pacific Islander and Filipino individuals were at two to three times higher risk of developing hypertensive disorders of pregnancy compared to Chinese individuals, after adjusting for sociodemographic and maternal health factors. In contrast, Japanese, Korean, and Vietnamese individuals generally had risks similar to the Chinese reference group. The lowest frequency of pregnancy-related high blood pressure was found in the Chinese subgroup at 3.7%, while the Guamanian subgroup had the highest frequency at 13%.
“There are known ways to help prevent and treat high blood pressure during pregnancy. Our findings can help health care professionals identify those who are at higher risk,” said study lead author Jennifer Soh, M.S., who conducted the research as a master’s student at Stanford University School of Medicine. “Early identification and treatment can help prevent serious, downstream complications for both the pregnant individuals and their infants.”
Pregnancy-related high blood pressure, including conditions such as gestational hypertension, preeclampsia, and eclampsia, increases the risk of heart attack and stroke and is a leading cause of maternal illness and death in the United States. According to the U.S. Centers for Disease Control and Prevention, about 1 in 7 pregnancies are affected by a high blood pressure-related condition. These conditions can be managed with medication or lifestyle changes, as noted by the American Heart Association.
Previous research has indicated that the risk of developing pregnancy-related high blood pressure differs among racial and ethnic groups due to social determinants of health. However, little was known about differences within Asian American, Native Hawaiian, and Pacific Islander populations, as they are often grouped together despite their diversity. This study analyzed records of 772,688 pregnant individuals who self-identified as belonging to one of 15 subgroups, including Chinese, Filipino, Hawaiian, Guamanian, Samoan, and others.
The researchers reviewed infant and fetal birth and death certificates linked to maternal hospital discharge records to identify five hypertensive disorders: chronic hypertension, gestational hypertension, preeclampsia, eclampsia, and chronic hypertension with preeclampsia. The analysis revealed that after adjusting for factors such as age, education, and health insurance, Filipino and Pacific Islander subgroups had significantly elevated risks compared to Chinese individuals.
“The observed racial-ethnic differences in risk highlight the variation in lived experiences of the individuals included in this study,” Soh said. “Future studies should examine more structural and social factors that could help explain the differences in the elevated risks found in this study.”
The study had several limitations, including reliance on medical diagnostic codes, which may be subject to underreporting or misclassification, and the fact that data only included individuals in California, so results may not apply to other communities. Additionally, the study could not account for the effects of the COVID-19 pandemic or factors such as air pollution, neighborhood walkability, and food access.
For more information, view the manuscript online. Multimedia is available on the right column of the release link.
