Abstract P163: Healthful Dietary Patterns and the Risk of Hypertension Among Women With a History of Gestational Diabetes

Background: Women who developed gestational diabetes (GDM) are at an increased risk for hypertension, compared with parous women without GDM. The role of diet in the progression to hypertension among this highly susceptible population is unknown. Methods: We conducted a prospective cohort study among 3,818 women with a history of GDM in the Nurses’ Health Study II, as a part of the ongoing Diabetes & Women’s Health Study. These women were followed from 1991 until 2011. Incident hypertension was identified by self-report with a previously validated questionnaire. Adherence scores for the 2010 Alternative Health Eating Index (AHEI-2010), the Alternate Mediterranean Diet (aMed) and the Dietary Approaches to Stop Hypertension (DASH) were computed for each participant; higher scores indicate better diet quality. Cox proportional hazard models were used adjusting for major risk factors for hypertension, including dietary and lifestyle factors, medical history, reproductive factors and medications. Results: We documented 1,069 incident hypertension cases during a median of 18.5 years follow-up. After multivariate adjustment, the AHEI-2010, and DASH scores were significantly and inversely associated with risk of hypertension. Hazard ratio (HR) and 95% confidence interval (CI) comparing the extreme quartiles (highest vs. lowest) was 0.78 (0.63-0.96, P for linear trend=0.02) for AHEI-2010, 0.77 (0.62-0.96, P for trend=0.02) for DASH score and 0.80 (0.65-0.99, P for trend=0.06) for aMed score. Conclusion: After GDM, adherence to a healthful dietary pattern was related to a lower risk of developing hypertension.