Why anxiety and mood disorders are skyrocketing in Canada — and who is being hit the hardest - Toronto Star

Rates of hypertensive disorders of pregnancy are rising nationwide and are at crisis levels in some communities. In Cuyahoga County, where Cleveland Clinic’s Main Campus, Fairview and Hillcrest hospitals are located, the condition now affects as many as one in three patients, says obstetrician/gynecologist Monique Yoder Katsuki, MD, MPH. Follow-up with a primary care provider is essential for these patients, not just during the postpartum period but for the rest of their lives. Hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia, are associated with an increased lifetime risk for cardiovascular disease. Patients may need routine health screenings at an earlier age and more frequently, as well as medication management that takes their future reproductive plans into account. “It’s really important to get a patient’s pregnancy-related history,” Dr. Katsuki says. “Did they have gestational diabetes? Were they on insulin? Did they have a hypertensive disorder of pregnancy? Did they have preeclampsia? Did they take blood pressure medication?

A Nature Reviews Neurology review from Dr. Geneviève Bernard’s lab points to one molecular process that keeps appearing in leukodystrophies. When Alexandra Chapleau walked into Dr. Geneviève Bernard’s lab in 2018 as a summer undergraduate student, unsure whether research was for her, she was inspired by her brother, who has leukodystrophy. It was what initially drew her to Dr. Bernard’s lab at The Institute in the Child Health and Human Development program.

MainHypertensive disorders of pregnancy (HDPs), including gestational hypertension (GHTN), preeclampsia, chronic hypertension (CHTN) with superimposed preeclampsia (PEC) and eclampsia, affect 2–15% of pregnancies and represent the second leading cause of maternal mortality worldwide1. HDPs increase the risk of acute maternal complications such as renal dysfunction, pulmonary edema, stroke and death2 and contribute to adverse fetal outcomes, including small for gestational age, preterm delivery and stillbirth3. Long-term, they are associated with elevated maternal risk of hypertension, coronary artery disease, stroke and vascular dementia4,5,6 and elevated offspring risk of cardiovascular and neurodevelopmental disorders7. Despite their burden, HDPs are typically diagnosed after 20 weeks of gestation, when symptoms such as hypertension, proteinuria or organ dysfunction become clinically apparent. Severe features, including systolic blood pressure (BP) ≥ 160 mmHg or diastolic BP ≥ 110 mmHg, thrombocytopenia and visual symptoms, guide early delivery decisions because of high maternal–fetal risk8.