Hashimoto Masayoshi, Miyamoto Yoshitomo, Iwai Chikao, Matsuda Yasuaki, Hiraoka Eiji, Kanazawa Kenji, Nishimura Kunihiro, Sugiyama Daisuke, Ito Kazuo, Yamori Yukio, Akita Hozuka
Department of General Internal Medicine, Kobe University School of Medicine, Kobe, Japan.
Circ J. 2009 Apr;73(4):750-4. doi: 10.1253/circj.cj-08-0441. Epub 2009 Feb 17.
Estrogen is considered to be cardioprotective, but estrogen replacement therapy for postmenopausal women has not shown results for either primary or secondary cardiovascular event prevention. During normal pregnancy, women have significantly higher levels of estrogen and it may be endogenous estrogen that helps prevent atherosclerosis.
The present cross-sectional study examined the association between pregnancy followed by delivery and clinical atherosclerosis using the brachial-ankle pulse wave velocity (PWV). A total of 2,560 women undergoing annual health screening at the Institute of Hyogo Prefecture Health Promotion Association in Japan were recruited. Pregnancy history (the age of menarche/menopause and the number of gravida/para), conventional coronary risk factors, and brachial-ankle PWV were recorded. Multivariate linear regression by stepwise selection analysis demonstrated that women who had 1 or more deliveries had a significantly lower PWV, independent of age and other conventional coronary risk factors.
Pregnancy followed by delivery may decrease arterial stiffness and prevent the progress of atherosclerosis in women. The contribution of such a pregnancy followed by delivery-related decrease in arterial stiffness to the reduction of cardiovascular disease in women should be further evaluated.
雌激素被认为具有心脏保护作用，但绝经后女性的雌激素替代疗法在预防原发性或继发性心血管事件方面均未显示出效果。在正常妊娠期间，女性体内的雌激素水平显著升高，可能正是内源性雌激素有助于预防动脉粥样硬化。
本横断面研究采用臂踝脉搏波速度（PWV）来检测妊娠并分娩与临床动脉粥样硬化之间的关联。共招募了2560名在日本兵库县健康促进协会研究所接受年度健康筛查的女性。记录其妊娠史（初潮/绝经年龄及妊娠次数/产次）、传统冠状动脉危险因素及臂踝PWV。通过逐步选择分析进行多变量线性回归表明，有1次或更多次分娩经历的女性，其PWV显著较低，且不受年龄及其他传统冠状动脉危险因素的影响。
妊娠并分娩可能会降低女性的动脉僵硬度，预防动脉粥样硬化进展。这种与妊娠并分娩相关的动脉僵硬度降低对女性心血管疾病减少的贡献应进一步评估。
