Departments of Internal Medicine and OB/GYN, Christiana Care Health System, Newark, Delaware 19718, USA.
Curr Opin Cardiol. 2013 Sep;28(5):547-53. doi: 10.1097/HCO.0b013e328364298e.
To review recent evidence regarding traditional and sex-specific factors identified among women during their reproductive years and their importance in lifetime risk for cardiovascular disease (CVD).
Longitudinal studies demonstrated a woman's burden of risk during her reproductive years is associated with future risk of CVD. Similarly, women with a healthy lifestyle are relatively protected and have the lowest lifetime risk. Some primary prevention strategies, when implemented during this age window, were cost-effective. The link between pregnancy outcome and future CVD risk is now better understood, and evidence now relates pregnancy-associated hypertension and diabetes, as well as a preterm delivery or a low birth weight delivery, to excess risk. Gaps in preventive healthcare for women in this age group included low rates of treatment initiation for hypertension and failure to follow guidelines for diabetes surveillance among women with a history of gestational diabetes. Knowledge gaps for standard CVD prevention, as well as the link between pregnancy complications and future CVD risk, were identified among both primary care providers and obstetrician/gynecologists.
Traditional and sex-specific risk factors for CVD present during women's reproductive years. Engaging the obstetrician/gynecologist provides a strategy to enhance prevention.
回顾女性生殖期内确定的传统和性别特异性因素的最新证据及其对心血管疾病(CVD)终生风险的重要性。
纵向研究表明,女性在生殖期的风险负担与未来 CVD 风险相关。同样,生活方式健康的女性受到相对保护,终生风险最低。一些在这个年龄段实施的一级预防策略具有成本效益。现在,人们对妊娠结局与未来 CVD 风险之间的联系有了更好的理解,证据表明与妊娠相关的高血压和糖尿病,以及早产或低出生体重分娩,与风险增加有关。该年龄段女性预防保健方面的差距包括高血压治疗起始率低,以及有妊娠糖尿病史的女性未能遵循糖尿病监测指南。初级保健提供者和妇产科医生都存在 CVD 预防标准知识差距以及妊娠并发症与未来 CVD 风险之间的联系。
CVD 的传统和性别特异性危险因素存在于女性的生殖期。妇产科医生的参与提供了增强预防的策略。