Dietary Patterns and Hypertensive Disorders of Pregnancy
Arvizu Boy, Mariel
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CitationArvizu Boy, Mariel. 2019. Dietary Patterns and Hypertensive Disorders of Pregnancy. Doctoral dissertation, Harvard T.H. Chan School of Public Health.
AbstractDespite the high frequency and burden of Hypertensive disorders of pregnancy (HDPs), little is known, about how adherence to diet patterns before pregnancy or during pregnancy relate to the risk of HDPs. Most of the research has focused on individual nutrients with inconclusive results. Moreover, the association between dietary patterns and risk of HDPs is scarce. In chapter I, we evaluated the association between adherence to dietary patterns aimed to prevent cardiovascular (CVD) in the general population with the risk of developing HDPs, specifically, Preeclampsia (PE) and gestational hypertension (GHTN) among participants of the Nurses’ Health Study-II. Women with higher adherence to the Dietary Approaches to Stop Hypertension (DASH) had 40% lower risk of preeclampsia compared to women with the lowest adherence. Moreover, higher adherence to the American Heart Association (AHA) diet recommendations from the 2020 Impact Goals had a marginal inverse association with risk of PE vs women with the lowest adherence. These associations were mainly explained by a higher intake of fruits and fruit juices, and lower intake of processed meats. Gestational hypertension was not associated with neither the AHA diet patterns nor the DASH diet.
In chapter 2, we examined the association between adherence to AHA and DASH diet patterns from 2nd trimester of pregnancy with the risk of PE and GHTN among participants of the Danish National Birth Cohort. Adherence to the AHA and DASH diet patterns were not associated to the risk of PE or GHTN among Danish women. However, lower sodium intake during pregnancy was related to lower risk of PE. For every increase of 817 mg/day of sodium intake was related to a 24% increase of HDPs. In addition, higher sodium intake was independently associated to PE and GHTN.
Women with pregnancies complicated by HDPs are at higher risk of developing CVD outcomes later-in life. Although numerous studies have evaluated the relation between diet and subsequent risk of CVD, the role of dietary patterns and hypertension (HTN) remains unclear, particularly among Mexican women. In chapter 3, we evaluated the association between adherence to AHA and DASH diet patterns and the risk of incident chronic HTN comparing women with and without history of HDPs. We used data from the Mexican Teachers’ Cohort and we found that higher adherence to both DASH and AHA diet patterns was not beneficial among women with history of HDPs; however, higher adherence to AHA and DASH diet patterns resulted in 13% lower risk of HTN in the overall population and among women without history of HDPs.
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