Losing Social Connections as We Age and Links to Hypertension Risk in Adults in Canada: A Gender-Sensitive Secondary Data Analysis Study of the Canadian Longitudinal Study on Aging (2011-2021)

BACKGROUND: Hypertensive disorders of pregnancy (HDP) are linked to long-term cardiovascular changes, but their impact on brain structure, particularly white matter hyperintensities (WMH), remains unclear.Gender-related factors like low education and income levels are associated with higher HDP incidence, but their role in the HDP-WMH relationship is unknown.In this study we examined whether sex-related factors modify the HDP-WMH association.METHODS: We included 1350 UK Biobank women (270 with HDP, 1080 without), aged 50 AE 7 years at recruitment (2006-2010) with at least 1 live birth.HDP was identified via ICD codes and self-reports, and WMH volume (measured using MRI, 2014-2022) was standardized for head size.Women with HDP were matched 1:4 to women with normotensive pregnancies according to delivery year and parity.Linear regression was used to assess HDP-WMH associations, incorporating a social index (sum of dichotomized sex-related variables) and its interaction with HDP, adjusting for age, age at first delivery, parity, waist-tohip ratio, gestational diabetes, depression, smoking, sleep, and alcohol use.RESULTS: WMH volumes were similar across groups (HDP: 3.0 mL [95% CI, 2.7-3.5];non-HDP: 2.7 mL [95% CI, 2.5-2.9]), and social index scores (HDP: 5.8 [95% CI, 5.5-6.1];non-HDP: 5.4 [95% CI, 5.3-5.6]).Multivariate analysis showed an association between HDP and WMH (b 0.4; 95% CI, 0.1-0.8)and between social index and WMH (b 0.11; 95% CI, 0.04-0.19).No interactions between social index and HDP (P 0.145) were found.CONCLUSIONS: HDP and sex-related factors are independently associated with increased WMH, with no interaction between them, highlighting the need to address social determinants and monitor brain health in women with HDP.