{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:52:07Z","timestamp":1791863527388,"version":"4.3.4"},"reference-count":58,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,7,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Gestational hypertension (GHTN) and preeclampsia are established risk indicators for chronic hypertension. While recurrence is associated with a greater risk, it is unclear whether there are differences in risk when these gestational complications occur for the first time in an earlier pregnancy versus first occurrence in a subsequent one. We hypothesized that the absence of recurrence reflects a transition toward a lower hypertension risk trajectory, whereas a new occurrence in a later pregnancy indicates a transition toward elevated risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">We analyzed linked data in Quebec, Canada, from public health care insurance administrative databases and birth, stillbirth, and death registries. Our retrospective cohort study included mothers with 2 singleton deliveries between April 1990 and December 2012. The primary exposure was patterns of GHTN or preeclampsia across 2 pregnancies (GHTN\/preeclampsia in neither, first only, second only, or both). The outcome was incident chronic hypertension. We performed an adjusted multivariable Cox regression analysis. Among 431\u2009980 women with 2 singleton pregnancies, 27\u2009755 developed hypertension during the follow\u2010up period. Compared with those without GHTN\/preeclampsia, those with GHTN\/preeclampsia only in the first pregnancy had a 2.7\u2010fold increase in hazards (95% CI, 2.6\u20132.8), those with GHTN\/preeclampsia only in the second had a 4.9\u2010fold increase (95% CI, 4.6\u20135.1), and those with GHTN\/preeclampsia in both pregnancies experienced a 7.3\u2010fold increase (95% CI, 6.9\u20137.6). Patterns and estimates were similar when we considered GHTN and preeclampsia separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The magnitude of hypertension risk is associated with the number and sequence of GHTN\/preeclampsia\u2010affected pregnancies. Considering both allows more personalized risk estimates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.034777","type":"journal-article","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T06:55:35Z","timestamp":1718952935000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Patterns of Gestational Hypertension or Preeclampsia Across 2 Pregnancies in Relationship to Chronic Hypertension Development: A Retrospective Cohort Study"],"prefix":"10.1161","volume":"13","author":[{"given":"Joseph","family":"Mussa","sequence":"first","affiliation":[{"name":"Department of Medicine McGill University Montreal Quebec Canada"},{"name":"Centre for Outcomes Research and Evaluation (CORE) Research Institute of the McGill University Health Centre (RI\u2010MUHC) Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4168-4993","authenticated-orcid":false,"given":"Elham","family":"Rahme","sequence":"additional","affiliation":[{"name":"Department of Medicine McGill University Montreal Quebec Canada"},{"name":"Centre for Outcomes Research and Evaluation (CORE) Research Institute of the McGill University Health Centre (RI\u2010MUHC) Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mourad","family":"Dahhou","sequence":"additional","affiliation":[{"name":"Centre for Outcomes Research and Evaluation (CORE) Research Institute of the McGill University Health Centre (RI\u2010MUHC) Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5833-5303","authenticated-orcid":false,"given":"Meranda","family":"Nakhla","sequence":"additional","affiliation":[{"name":"Centre for Outcomes Research and Evaluation (CORE) Research Institute of the McGill University Health Centre (RI\u2010MUHC) Montreal Quebec Canada"},{"name":"Department of Pediatrics McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2447-3553","authenticated-orcid":false,"given":"Kaberi","family":"Dasgupta","sequence":"additional","affiliation":[{"name":"Department of Medicine McGill University Montreal Quebec Canada"},{"name":"Centre for Outcomes Research and Evaluation (CORE) Research Institute of the McGill University Health Centre (RI\u2010MUHC) Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(21)01330-1"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.121.025167"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.115.018912"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.119.14240"},{"key":"e_1_3_2_6_2","volume-title":"StatPearls","author":"Tackling G","year":"2023","unstructured":"Tackling G, Borhade MB. 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