{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T05:20:23Z","timestamp":1787721623409,"version":"build-2784847793"},"reference-count":44,"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":[[2026,7,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Hypertensive disorders of pregnancy (HDP) are associated with elevated long\u2010term risks of cerebrovascular disease. Emerging data suggest a link between HDP and dementia, potentially mediated by cerebral small vessel disease. We aimed to evaluate whether women with a history of HDP have more cerebral small vessel disease compared with women without HDP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This retrospective cohort study included 1602 women from the Utah Population Database who underwent brain magnetic resonance imaging after their index pregnancy. Magnetic resonance imaging scans were evaluated for white matter hyperintensities, remote brain infarctions, cerebral microhemorrhages, enlarged perivascular spaces, acute infarction, and cerebral volume loss. Multivariable regression models assessed the association between HDP and imaging findings, adjusting for confounding factors. Interrater reliability was evaluated using Cohen's kappa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Women with a history of HDP had higher white matter hyperintensities burden (adjusted mean difference, 0.57 [95% CI, 0.25\u20130.90];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.001), more total remote brain infarctions (adjusted mean difference, 0.11 [95% CI, 0.00\u20130.21];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.05) and enlarged perivascular spaces (adjusted mean difference, 0.14 [95% CI, 0.01\u20130.27];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.03) compared with women without an HDP history. No significant differences were found in microhemorrhages or cerebral volume loss. Subgroup analysis revealed stronger associations between HDP and cerebral small vessel disease markers among women without history of midlife hypertension or stroke, and those in the earlier index pregnancy cohort; though, effect modification was not statistically significant (all Wald interaction tests\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &gt;0.10). Interrater agreement was high across imaging measures (weighted kappa range: 0.89\u20131.00).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Women with prior HDP show greater imaging evidence of cerebral microvascular injury decades after pregnancy, supporting HDP as a risk factor for later\u2010life cerebrovascular health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046304","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:38:00Z","timestamp":1782211080000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Hypertensive Disorders of Pregnancy Associated With Cerebral Small Vessel Disease Decades Later"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6251-5769","authenticated-orcid":false,"given":"Hediyeh","family":"Baradaran","sequence":"first","affiliation":[{"name":"Columbia University","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8394-045X","authenticated-orcid":false,"given":"Sinead","family":"Culleton","sequence":"additional","affiliation":[{"name":"University of Utah","place":["Salt Lake City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5662-6040","authenticated-orcid":false,"given":"Lauren","family":"Theilen","sequence":"additional","affiliation":[{"name":"University of Utah","place":["Salt Lake City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9455-3973","authenticated-orcid":false,"given":"Michael W.","family":"Varner","sequence":"additional","affiliation":[{"name":"University of Utah","place":["Salt Lake City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8369-8369","authenticated-orcid":false,"given":"Emily","family":"Guinto","sequence":"additional","affiliation":[{"name":"University of Utah","place":["Salt Lake City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1771-3157","authenticated-orcid":false,"given":"Karen C.","family":"Schliep","sequence":"additional","affiliation":[{"name":"University of Utah","place":["Salt Lake City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.036748"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.04.002"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.07.170"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.116.003497"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.4097"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17038"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7117a1"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.122.19399"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16201"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k4109"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/dad2.12443"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c3666"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2018.3122"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2021-326569"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70060-7"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cccb.2024.100204"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.70972"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00131-X"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/pmf2.70020"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.124.22857"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003765"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","unstructured":"Hussainali RF Adank MC Lamballais S Vernooij MW Ikram MA Steegers EA Miller EC Schalekamp\u2010Timmermans S. 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