Trends in Hypertensive Disorders of Pregnancy Rates by Race and Ethnicity in the United States, 2016–2024

To evaluate contemporary trends in hypertensive disorders of pregnancy (HDP) prevalence by race and ethnicity, we conducted a cross-sectional study of 33,363,927 U.S. live births from 2016 through 2024 using National Vital Statistics System data. Age-standardized HDP rates increased by 74%, from 62.7 to 109.1 per 1,000 live births (average annual percent change 7.2%; p<0.001), with an inflection point occurring in 2021. This increment occurred across all racial and ethnic groups, with the highest relative increases among non-Hispanic Asian (9.7% annually) and Multiracial individuals (7.9% annually). By 2024, absolute HDP rates were highest among non-Hispanic American Indian or Alaska Native individuals (143.7/1,000) and non-Hispanic Black individuals (132.7/1,000).