Increased risk of systemic lupus erythematosus in pregnancy-induced hypertension

Abstract

Dysregulation of the immune system plays a role in the pathogenesis of both, pregnancy-induced hypertension (PIH) and systemic lupus erythematosus (SLE). It is well known that SLE predisposes to be complicated with PIH. However, few studies have attempted to investigate whether PIH increased subsequent SLE risk.The objectives of this study were to assess the association between PIH and subsequent SLE risk and identify predictive risk factors.Patients with newly diagnosed PIH were selected from the Taiwan National Health Insurance Research Database (NHIRD) and compared with a matched cohort without PIH based on age and the year of delivery. The incidence of new-onset SLE was evaluated in both cohorts. The overall observational period was from January 1, 2000 to December 31, 2013.Among the 23.3 million individuals registered in the NHIRD, 29,091 patients with PIH and 116,364 matched controls were identified. The incidence of SLE was higher among patients with PIH than in the matched controls (incidence rate ratio [IRR] = 4.02, 95% confidence interval [CI] 3.98–4.05, P < 0.0001). The IRR for subsequent SLE development remained significantly higher in all stratifications during the follow-up years. The multivariate Cox regression model was performed and the results showed that PIH may be an independent risk factors for the development of subsequent SLE (hazard ratio [HR] = 2.87, 95% CI 2.07–3.98, P < 0.0001). Moreover, multivariate Cox regression model was used again among the PIH cohort only in order to identify the possible risk factors for subsequent SLE in the population with PIH.Patients with PIH may have higher risk of developing newly diagnosed SLE than those without PIH. In addition, among individuals who have experienced PIH, those younger than 30 years, having experienced preeclampsia/eclampsia, single parity, preterm birth, or chronic kidney disease, may display an increased subsequent risk of SLE.

ATP release drives heightened immune responses associated with hypertension

“…Thus, in three separate mouse models of immune challenge, there was a consistent pattern of an increased T cell-mediated immune response associated with an elevation of BP, which is due to aberrant immune activation in hypertensive mice. Although many clinical studies indicate that hypertension is one of the most common comorbidities of many autoimmune diseases (41,42), our animal studies provide evidence and mechanistic insight into why there is an association between hypertension and high prevalence of autoimmune disease, even in humans (9–11).…”

“…What is not well understood is the cause of the hypertension-associated inflammatory response and the temporal relationship between the elevation of BP and the onset of inflammation. Further, very little is known about the precise effects of hypertension on immune responses, although clinical studies indicate a positive correlation between hypertension and autoimmune diseases (9–11).…”

Avoiding excessive pregnancy weight gain to obtain better pregnancy outcomes in Taiwan

“…On the contrary, our study was carried out in a short time and in a population that inhabits a country area free of environmental pollution. In addition, all women received a similar prenatal and perinatal care based on the Taiwan's National Health Insurance program [ 45 , 46 ] along with the individual 15-minute dietary and lifestyle education program.…”

The Pathogenesis and Influencing Factors of Adult Hypertension Based on Structural Equation Scanning

“…Hypertension is currently one of the main diseases threatening human health, it not only caused serious physical, mental, and economic damage to patients but also brings a significant economic burden of disease to all mankind. Hypertension is a disease caused by multiple causes; according to research, hypertension is affected by the interaction of genetic, social, and lifestyle factors, with the improvement of living standards; the choice of diet has increased; obesity among adolescents is also increasing; as a result, hypertensive patients are gradually becoming youthful, which further makes hypertension an important public health problem [ 1 ]. In addition, the complications caused by high blood pressure cannot be ignored; in China, hypertension combined with coronary heart disease is more common.…”