Women with a history of gestational diabetes who adhered to a healthy dietary pattern had a lower risk of developing hypertension, according to data recently published in Hypertension.
Gestational diabetes is associated with a higher risk for hypertension later in life. Therefore, early prevention could benefit women with a history of gestational diabetes.
In the current study, researchers examined the associations between long-term adherences to 3 healthy diet patterns with the subsequent risk of hypertension among women with a history of gestational diabetes.
Although healthy diet and lifestyle factors help to lower risk of hypertension in the general population, it is unknown how healthy diet patterns can affect the risk in this susceptible population, and such information is critical for the development of a targeted prevention strategy.
“We observed an inverse association between adherence to healthful dietary patterns, AHEI [alternative Healthy Eating Index-2010), DASH [Dietary Approaches to Stop Hypertension], or Mediterranean diet [aMed], and risk of hypertension later in life,” the authors wrote. “Comparing extreme categories, women consuming a higher quality diet after [gestational diabetes] had on average a 20% lower risk of subsequent hypertension. Increase in BMI explained around 20% to 30% of the association between healthful dietary patterns and hypertension.”
Researchers selected 3818 women with a history of gestational diabetes from the Nurses’ Health II study, who were then followed from 1989 to 2011. Patients completed self-administered questionnaires to identify incident hypertension that were validated by medical record review.
Adherence scores for AHEI-2010, the Mediterranean diet, and the DASH were also calculated for each patient.
A total of 1069 cases of incident hypertension were documented during a median follow-up period of 18.5 years. Women who followed AHEI, DASH, or aMed diets were less likely to be current smokers or consume trans fat, and more likely to be moderate alcohol drinkers, eat more cereal fiber, and be more physically active.
After adjusting for hypertension risk factors, including body mass index (BMI), the AHEI, aMed, and DASH scores were inversely associated with risk of hypertension. The hazard ratio (HR) comparing the lowest and highest quartiles was 0.76 for AHEI score (95% confidence interval [CI]: 0.61-0.94; P for linear trend=.03), 0.72 for DASH score (95% CI: 0.58-0.90; P=.01), and 0.70 for aMed score (95% CI: 0.56-0.88; P=.002).
“Findings … indicate that women with a history of [gestational diabetes] may benefit from adhering to a healthy dietary pattern characterized by rich intake in fruits and vegetables, whole grains, and low in red and processed meats, and low in refined grain,” the authors noted.
They added that the observed associations were affected by changes in BMI, which suggests that maintaining a healthy body weight is a key factor in preventing hypertension among high-risk women.
Li S, Zhu Y, Chavarro JE, et al. Healthful dietary patterns and the risk of hypertension among women with a history of gestational diabetes: a prospective cohort study. Hypertension. 2016. doi: 10.1161/HYPERTENSIONAHA.115.06747.