Research published today in the Journal of the American Heart Association reveals significant disparities in pregnancy-related high blood pressure risks among different Asian American, Native Hawaiian and Pacific Islander subgroups. The study, which analyzed California health records from 2007-2019, found that Pacific Islander and Filipino individuals faced two to three times higher risk than Chinese individuals, even after adjusting for sociodemographic and maternal-health factors.
The analysis of 772,688 pregnant individuals identified Chinese subgroups as having the lowest frequency of pregnancy-related high blood pressure at 3.7%, while Guamanian subgroups had the highest at 13%. Japanese, Korean and Vietnamese individuals generally showed risks comparable to the Chinese reference group. The findings challenge the common practice of grouping these diverse populations together in medical research and highlight the need for more nuanced healthcare approaches.
Pregnancy-related high blood pressure conditions, which include chronic hypertension, gestational hypertension, preeclampsia, eclampsia and chronic hypertension with preeclampsia, represent serious health concerns. According to the U.S. Centers for Disease Control and Prevention, these conditions increase the risk of heart attack and stroke and are leading causes of maternal illness and death. Approximately 1 in 7 pregnancies in the United States are affected by high blood pressure-related conditions, though they can often be managed with medication or lifestyle changes as noted by the American Heart Association.
"There are known ways to help prevent and treat high blood pressure during pregnancy. Our findings can help health care professionals identify those who are at higher risk," said study lead author Jennifer Soh, M.S., formerly of Stanford University School of Medicine. "Early identification and treatment can help prevent serious, downstream complications for both the pregnant individuals and their infants."
The research examined five hypertensive disorders of pregnancy across 15 distinct subgroups: Chinese, Japanese, Korean, Vietnamese, Cambodian, Thai, Laotian, Hmong, Indian, Filipino, Other Asian, Hawaiian, Guamanian, Samoan and Other Pacific Islander. The study's limitations include its reliance on California data, which may not apply to other regions, and its inability to account for factors like air pollution, neighborhood walkability and food access. The research also could not consider the effects of the COVID-19 pandemic since the study period ended before its onset.
"The observed racial-ethnic differences in risk highlight the variation in lived experiences of the individuals included in this study," Soh noted, suggesting that future research should examine structural and social factors that could explain the elevated risks found in certain populations. The American Heart Association provides additional health information on pregnancy and maternal health through their resources available at https://www.heart.org/en/health-topics/pregnancy-and-maternal-health.
This research underscores the importance of moving beyond broad racial and ethnic categories in medical research and clinical practice. By recognizing the distinct health risks faced by different subgroups within the Asian American, Native Hawaiian and Pacific Islander communities, healthcare providers can develop more targeted prevention strategies and improve maternal health outcomes for all populations.
