Background
Hypertensive disorders of pregnancy (HDP) are associated with increased risk of cardiovascular disease. Neighbourhood characteristics may provide critical insight into how social and structural determinants of health impact an individual’s risk for these conditions.
Methods
We estimated annual prevalence of any HDP, preeclampsia, and gestational hypertension (GH) in adults discharged from an Ontario hospital for obstetrical delivery from 2002-2020. Data were retrieved from population-based administrative databases at ICES. Joinpoint regression was used to assess temporal trends and identify differences in the average annual average percent change (AAPC) of HDP prevalence by neighborhood-level proportion of visible minorities (i.e., proportion of residents who self-identified as a visible minority).
Results
The prevalence of HDP increased significantly over the study period, from 5.4% (5.2%-5.5%) to 7.5% (7.4%-7.7%). Similar increases were also found for preeclampsia and GH (1.3% to 2.2% and 3.4% to 4.6%, respectively, p<0.0001). The average prevalence of HDP was significantly higher in neighborhoods with the lowest vs highest proportion of visible minorities (6.9% vs 5.2%, p<0.0001). No significant difference in the relative increase of these conditions was observed during the study period [AAPC neighborhoods with lowest vs highest proportion of visible minorities: 2.0% vs 2.5%, p=0.300 (HDP); 3.0% vs 3.8%, p=0.691 (preeclampsia); 1.9% vs 2.4%, p=0.640 (GH)].
Conclusions
The prevalence of HDP has increased significantly in Ontario since 2002. Lower prevalence of HDP associated with higher neighborhood proportion of visible minorities suggests that neighborhood characteristics may influence HDP risk. Future studies should examine whether confounding factors account for this association.
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Copyright
© 2023 Published by Elsevier Inc.
