Development of Health Guidance for the Prevention of Hypertension in Adult Women with Histories of Hypertensive Disorders of Pregnancy

Abstract

This study examines methods for health guidance aimed at hypertension prevention in adult women with a history of hypertensive disorders of pregnancy (HDP).

A history of HDP is known to be a risk factor for future hypertension and stroke; however, the mechanism, prevention, and support systems have not been established. This is because, in most cases, blood pressure improves after delivery and blood pressure management is left to the women. Moreover, non-regular employees in Japan have limited opportunities for blood pressure monitoring because of the low participation rate in annual health checkups. Therefore, we investigate the evidence for the prevention of hypertension in middle-aged women with a history of HDP.

First, using data from approximately 60,000 women aged 40-74 years lived in 16 municipalities in 7 regions of Japan who participated in the JPHC-NEXT survey conducted between 2011 and 2016, we examine the prevalence of subsequent hypertension among those with a history of gestational hypertension and whether lifestyle behaviors such as diet and exercise can prevent future hypertension.

We will then combine the results of the next survey conducted five years later with information on new cases of hypertension since the first survey to show what lifestyle factors in midlife influence future hypertension in women with a history of HDP and what preventive measures can be taken to prevent the onset of hypertension.

In addition, 300 mothers who participate in a study of lifestyle-related diseases in children and their mothers (the Suita Offspring Study) will be examined and their blood pressure measured at home. We will assess whether the mothers have hypertension at health examination and home blood pressure by the presence or absence of HDP history and provide women with a history of HDP with health guidance based on the findings of the study. We also evaluate the effectiveness of its implementation.

Perspectives

• The importance of health guidance for midlife women according to their history of HDP is demonstrated.
• The National Cerebral and Cardiovascular Center is currently developing a maternal and child health handbook. By reflecting the study results of this study into this application, lifestyle recommendations to prevent future hypertension will be widely available through the application to women who have experienced HDP.

Comments from principal researcher

Haruna Kawachi (National Cerebral and Cardiovascular Center, Department of Preventive Cardiology, Part-time researcher）

Although there are many opportunities for people in Japan to receive health check-ups from birth to old age, the system for continuous health support and measures against lifestyle-related diseases throughout life is still insufficient, as various departments managing health information are responsible for different stages of life. In this study, we examine the combination of several pieces of information from a woman's gestational period through her middle age, and by demonstrating the results, we believe we can propose the possibility of support that transcends the gap between one life stage and the next.

Shared Researchers

Ayami Ono
National Cancer Center
Institute for cancer control

Naho Morisaki
National Center for Child Health and Development
Department of Social Medicine