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早发型子痫前期病史女性的心血管疾病危险因素。

Cardiovascular disease risk factors in women with a history of early-onset preeclampsia.

机构信息

Division of Perinatology and Gynecology, the Laboratory for Clinical Chemistry and Hematology, and the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; and the Division of Human Development and Health, University of Southampton, Southamptom, United Kingdom.

出版信息

Obstet Gynecol. 2013 May;121(5):1040-1048. doi: 10.1097/AOG.0b013e31828ea3b5.

Abstract

OBJECTIVE

To assess the prevalence of established cardiovascular disease risk factors and to estimate 10-year absolute risk of cardiovascular disease after early-onset preeclampsia.

METHODS

We assessed major cardiovascular disease risk factors in 243 primiparous women with a history of early-onset preeclampsia (delivery at less than 34 weeks of gestation) at least 6 months after delivery; 374 healthy nonpregnant women of similar age served as a reference group.

RESULTS

After adjustment for age, we observed significantly higher means for body mass index, blood pressure, total and low-density lipoprotein cholesterol, triglycerides, glucose, and lower mean high-density lipoprotein cholesterol (all P<.01) in women with previous early-onset preeclampsia compared with the reference group. Prevalence of the metabolic syndrome was 15.2% compared with 4.3% (P<.001), two or more major cardiovascular disease risk factors were present in 51.0% compared with 26.5%, and three or more risk factors were present in 18.9% compared with 6.4%, respectively. Mean estimated 10-year cardiovascular disease risks by the Framingham Risk Score were 1.08% (95% confidence interval 1.04-1.12) and 1.01% (95% CI 1.00-1.01; P<.001) for the difference.

CONCLUSION

Women with a history of early-onset preeclampsia have a high prevalence of several major cardiovascular disease risk factors. Although the estimated 10-year cardiovascular disease risk is low (less than 5%) after delivery, cardiovascular disease risk is expected to increase rapidly with increasing age.

LEVEL OF EVIDENCE

II.

摘要

目的

评估已确立的心血管疾病危险因素的流行情况,并估计早发型子痫前期后 10 年心血管疾病的绝对风险。

方法

我们评估了 243 名有早发型子痫前期(分娩在 34 周之前)病史且产后至少 6 个月的初产妇的主要心血管疾病危险因素;374 名年龄相似的健康未怀孕女性作为参考组。

结果

调整年龄后,我们观察到与参考组相比,既往早发型子痫前期的女性体重指数、血压、总胆固醇和低密度脂蛋白胆固醇、甘油三酯、血糖均显著升高(均 P<.01),高密度脂蛋白胆固醇水平较低(均 P<.01)。代谢综合征的患病率为 15.2%,而参考组为 4.3%(P<.001);51.0%的患者存在两种或更多的主要心血管疾病危险因素,而参考组为 26.5%;3 种或更多危险因素的患者占 18.9%,而参考组为 6.4%。应用弗雷明汉风险评分估计的 10 年心血管疾病风险平均值分别为 1.08%(95%置信区间 1.04-1.12)和 1.01%(95%CI 1.00-1.01;P<.001)。

结论

早发型子痫前期病史的女性存在多种主要心血管疾病危险因素的高发。尽管产后的 10 年心血管疾病风险较低(低于 5%),但随着年龄的增长,心血管疾病风险预计会迅速增加。

证据水平

II。

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