Patterns of pregnancy-related hypertension in black and white women

Objective. To determine whether the higher rate of preeclampsia previously reported in Black women is attributable to a higher rate of chronic hypertension in that group. Methods. Rates and severity of pregnancy-related hypertensive disease in Black and White women with and without chronic hypertension were reviewed from the medical records of our institution. Results. Of 1,355 records reviewed, evidence of hypertensive disease was noted in 101 singleton pregnancies. Hypertension during pregnancy occurred in 7.4% of Black and 7.4% of White women. Among women with hypertension in pregnancy but no chronic hypertension, Blacks were more likely to be diagnosed with preeclampsia (78 vs. 53%, p = 0.04) and more likely to have had systolic blood pressures >160 mmHg (43 vs. 17%, p = 0.01). However, the rates of severe preeclampsia were similar in Black and White women since Whites were more likely to be diagnosed with severe preeclampsia in the absence of very high systolic blood pressures. Black multiparous patients with hypertension were three times more likely than White multiparous patients to be diagnosed with preeclampsia (80 vs. 27%, p = 0.01). Conclusions. In our population, Black women with hypertension in pregnancy in the absence of chronic hypertension were more likely to be diagnosed with preeclampsia than were White women. This finding suggests that the higher rate of preeclampsia among Black women is not completely explained by higher rates of chronic hypertension in that group.