Global and Chinese Trends in Maternal Hypertensive Disorders (1990–2023)

Maternal hypertensive disorders (MHD) remain a significant contributor to maternal and neonatal morbidity worldwide. A recent study analyzing maternal hypertensive disorders trends from 1990 to 2023 provides a detailed comparison between China and the global landscape. While the overall disease burden has decreased, the findings highlight an emerging challenge: the rising risk among older pregnant women. Understanding these shifts is essential for clinicians managing high-risk pregnancies today.

A Dramatic Decline in Disease Burden

Between 1990 and 2023, China achieved remarkable progress in reducing the impact of pregnancy-related hypertension. Incident cases dropped by nearly 80%, while disability-adjusted life years (DALYs) plummeted by over 95%. Furthermore, China's age-standardized rates consistently stayed below the global average. This decline reflects substantial improvements in prenatal screening and perinatal management within the region. However, the global trend shows a more moderate reduction, indicating that many regions still struggle with high incidence rates.

Maternal Hypertensive Disorders Trends and the Impact of Age

The study utilized Age-Period-Cohort (APC) models to identify specific risk patterns. One of the most striking findings concerns the age of the mother. Globally, the incidence of hypertensive disorders has declined across all age groups. In contrast, China reported a significant increase in incidence among women aged 35 to 54. The 45-49 age group saw the sharpest rise, with a yearly increase of over 3%. Consequently, this demographic shift necessitates specialized care for women of advanced maternal age.

Future Outlook and Clinical Implications

Projections through 2035 suggest that the overall burden will continue to fall. Nevertheless, the rising risk in older cohorts remains a critical public health concern. Clinicians should prioritize early screening and aggressive monitoring for these patients. Moreover, tailored interventions that address specific age-related risks can further reduce the mortality associated with eclampsia and preeclampsia. These maternal hypertensive disorders trends emphasize the need for robust, age-based healthcare strategies.

Frequently Asked Questions

Why is the risk of hypertension rising in older pregnant women?

Older age often correlates with higher rates of pre-existing comorbidities such as obesity and chronic hypertension. These factors, combined with physiological changes during pregnancy, significantly elevate the risk of developing gestational hypertensive disorders.

How should clinicians adapt to these evolving trends?

Healthcare providers should implement enhanced screening protocols for women over 35 years. Frequent blood pressure monitoring and early identification of warning signs are vital to preventing severe complications like eclampsia.

Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice or a professional opinion. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Liu B et al. Comparison of the burden of maternal hypertensive disorders between China and the globe from 1990 to 2023: epidemiological trends and age-period-cohort analysis. Hypertens Pregnancy. 2026 Dec 31. doi: 10.1080/10641955.2026.2634182. PMID: 41749422.

Wang Y et al. Global, Regional, and National Burden and Trends of Maternal Hypertensive Disorders from 1990 to 2021: A Population-Based Study. Int J Womens Health. 2025;17:211-225.

Shabil M et al. Maternal hypertensive disorders among individuals of reproductive age in South Asia: A Global Burden of Disease study (1990-2021) with future projections. South Asia J Med. 2025 Mar 7.