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妊娠晚期高血压疾病患者的心血管危险因素:队列研究。

Cardiovascular risk factors in women who had hypertensive disorders late in pregnancy: a cohort study.

机构信息

Department of Obstetrics and Gynecology at Vu University Medical Center, Amsterdam, The Netherlands.

出版信息

Am J Obstet Gynecol. 2013 Jun;208(6):474.e1-8. doi: 10.1016/j.ajog.2013.02.016. Epub 2013 Feb 8.

Abstract

OBJECTIVE

The purpose of this study was to determine cardiovascular risk factors in women with a history of hypertensive pregnancy disorders at term (HTP) 2.5 years after pregnancy.

STUDY DESIGN

In a multicenter cohort study in The Netherlands from June 2008 through November 2010, cardiovascular risk factors were compared between women with a history of HTP (HTP cohort, n = 306) and women with a history of normotensive pregnancies at term (NTP cohort, n = 99). HTP women had participated in a randomized, longitudinal trial assessing the effectiveness of induction of labor in women with hypertensive pregnancy disorders at term. All women were assessed 2.5 years after pregnancy for blood pressure, anthropometrics, glucose, glycosylated hemoglobin, insulin, homeostatic model assessment score, total cholesterol, high-density lipoprotein cholesterol, triglycerides, high-sensitivity C-reactive protein, and microalbumin and metabolic syndrome.

RESULTS

After a mean follow-up period of 2.5 years, hypertension (HTP, 34%; NTP, 1%; P < .001) and metabolic syndrome (HTP, 25%; NTP, 5%; P < .001) were more prevalent in HTP women compared with NTP women. HTP women had significantly higher systolic and diastolic blood pressure, higher body mass index, and higher waist circumference. Glucose, glycosylated hemoglobin, insulin, homeostatic model assessment score, total cholesterol, triglycerides, and high-sensitivity C-reactive protein levels were significantly higher and high-density lipoprotein cholesterol was significantly lower in HTP women.

CONCLUSION

In women with a history of HTP, hypertension and metabolic syndrome are more common, and they have higher levels of biochemical cardiovascular risk factors 2.5 years after pregnancy.

摘要

目的

本研究旨在确定足月妊娠高血压疾病史(HTP)女性 2.5 年后的心血管危险因素。

研究设计

本研究为 2008 年 6 月至 2010 年 11 月在荷兰进行的一项多中心队列研究,比较了有 HTP 病史的女性(HTP 队列,n=306)和有正常血压足月妊娠史的女性(NTP 队列,n=99)的心血管危险因素。HTP 女性曾参加过一项评估足月妊娠高血压疾病妇女引产效果的随机、纵向试验。所有女性在妊娠后 2.5 年评估血压、人体测量学、血糖、糖化血红蛋白、胰岛素、稳态模型评估评分、总胆固醇、高密度脂蛋白胆固醇、甘油三酯、高敏 C 反应蛋白、微量白蛋白和代谢综合征。

结果

平均随访 2.5 年后,HTP 女性(34%)高血压和代谢综合征(25%)的患病率明显高于 NTP 女性(1%和 5%)(均 P <.001)。与 NTP 女性相比,HTP 女性的收缩压和舒张压更高,体重指数和腰围更大。HTP 女性的血糖、糖化血红蛋白、胰岛素、稳态模型评估评分、总胆固醇、甘油三酯和高敏 C 反应蛋白水平明显更高,高密度脂蛋白胆固醇水平明显更低。

结论

在 HTP 病史的女性中,高血压和代谢综合征更为常见,且妊娠 2.5 年后生化心血管危险因素水平更高。

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