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Hypertensive Disorders of Pregnancy Associated With Cerebral Small Vessel Disease Decades Later

Hediyeh Baradaran1, Sinead Culleton2, Lauren Theilen3

  • 1Department of Radiology Columbia University New York NY USA.

Journal of the American Heart Association
|June 23, 2026
PubMed

Insights

Women with a history of hypertensive disorders of pregnancy (HDP) show increased signs of cerebral small vessel disease, including white matter hyperintensities and brain infarctions, decades after childbirth. This suggests HDP is a risk factor for long-term cerebrovascular health.

Area of Science:

  • Neurology
  • Obstetrics
  • Cardiovascular Health

Background:

  • Hypertensive disorders of pregnancy (HDP) are linked to increased long-term risks of cerebrovascular disease.
  • Emerging evidence suggests a connection between HDP and dementia, possibly due to cerebral small vessel disease.
  • This study investigates if HDP history correlates with greater cerebral small vessel disease markers.

Purpose of the Study:

  • To determine if women with a history of hypertensive disorders of pregnancy (HDP) exhibit more cerebral small vessel disease compared to those without.
  • To evaluate specific markers of cerebral small vessel disease on brain MRI in women with and without HDP history.

Main Methods:

  • Retrospective cohort study of 1602 women from the Utah Population Database.
  • Brain MRI scans analyzed for white matter hyperintensities, remote infarctions, microhemorrhages, enlarged perivascular spaces, acute infarction, and cerebral volume loss.
  • Multivariable regression models assessed the association between HDP and MRI findings, controlling for confounders.

Main Results:

  • Women with HDP history showed significantly higher burdens of white matter hyperintensities, remote brain infarctions, and enlarged perivascular spaces.
  • No significant differences in cerebral microhemorrhages or cerebral volume loss were observed between groups.
  • Subgroup analyses indicated potentially stronger associations in specific cohorts, though not statistically significant.

Conclusions:

  • Prior HDP is associated with greater evidence of cerebral microvascular injury detected via MRI, even decades after pregnancy.
  • These findings support hypertensive disorders of pregnancy as a significant risk factor for later-life cerebrovascular health.
  • The study highlights the importance of long-term monitoring of cerebrovascular health in women with a history of HDP.
Abstract

Keywords:
cerebral small vessel diseasecerebrovascular diseasehypertensive disorders of pregnancyvascular cognitive impairmentwhite matter hyperintensities

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