Hypertension affects nearly one of three women in the United States. Breastfeeding leads to metabolic changes that could reduce risks of hypertension. Hypertension disproportionately affects black women, but rates of breastfeeding lag behind the general population. In the Black Women’s Health Study (N = 59,001), we conducted a nested case control analysis using unconditional logistic regression to estimate the association between breastfeeding and incident hypertension at ages 40-65. Controls were frequency matched 2:1 to 12,513 hypertensive cases by age and questionnaire cycle. Overall, there was little evidence of association between ever-breastfeeding and incident hypertension (Odds ratio 0.97, 95% CI: 0.92, 1.02). However, age modified the relationship (P = 0.02): breastfeeding was associated with reduced risk of hypertension at ages 40-49 (Odds ratio 0.92, 95% CI: 0.85, 0.99) but not older ages. Our results suggest long-duration breastfeeding may reduce incident hypertension in middle age.
Learning Objectives:
Objective 1: Review importance of equity in research populations for both breastfeeding and hypertension
Objective 2: Describe the benefits of a nested case control design in limiting both selection and survival bias when studying the association between cumulative lifetime lactation and hypertension
Objective 3: Quantify the protective association between cumulative lifetime lactation and hypertension.
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