Brown Catherine M, Turner Stephen T, Bailey Kent R, Mosley Thomas H, Kardia Sharon L R, Wiste Heather J, Kullo Iftikhar J, Garovic Vesna D
aDivision of Nephrology and Hypertension bDivision of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota cUniversity of Mississippi Medical Center, Jackson, Mississippi dDepartment of Epidemiology, University of Michigan, Ann Arbor, Michigan eDivision of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
J Hypertens. 2013 Nov;31(11):2213-9; discussion 2219. doi: 10.1097/HJH.0b013e3283642f6c.
We assessed whether hypertension in pregnancy is associated with elevated C-reactive protein (CRP) levels in later life, possibly reflecting an increased risk of cardiovascular disease (CVD).
Elevated CRP levels have been associated with hypertension in pregnancy and with CVD.
We studied 2463 women from the Genetic Epidemiology Network of Arteriopathy (GENOA) study. Participants were categorized as nulliparous women (n = 219), women with a history of normotensive pregnancies (n = 1839), or women with a history of a hypertensive pregnancy (n = 405). Using multiple linear regression models, we compared mean CRP levels among the groups after adjusting for age, race, education, smoking, hypertension, personal history of coronary heart disease (CHD) or stroke, diabetes, dyslipidemia, statins, hormone replacement therapy, and family history of CHD or stroke. As CRP levels may be influenced by BMI, the model was fit both with and without adjusting for BMI.
There was no significant difference in CRP levels between nulliparous women and those with a history of normotensive pregnancies, either with (P = 0.82) or without (P = 0.46) adjusting for BMI. In contrast, women with hypertensive pregnancies, compared with those with normotensive pregnancies, had higher CRP levels, both with (P = 0.009) and without (P < 0.001) adjusting for BMI.
A history of hypertension in pregnancy is associated with elevated CRP levels later in life, independent of traditional CVD risk factors and BMI. An elevated CRP may reflect an inflammatory state in women with a history of hypertensive pregnancy disorders who are at increased risk for CVD.
我们评估了孕期高血压是否与晚年C反应蛋白(CRP)水平升高有关,这可能反映了心血管疾病(CVD)风险的增加。
CRP水平升高与孕期高血压及CVD有关。
我们对动脉病遗传流行病学网络(GENOA)研究中的2463名女性进行了研究。参与者被分为未生育女性(n = 219)、有血压正常妊娠史的女性(n = 1839)或有高血压妊娠史的女性(n = 405)。使用多元线性回归模型,在调整年龄、种族、教育程度、吸烟、高血压、冠心病(CHD)或中风个人史、糖尿病、血脂异常、他汀类药物、激素替代疗法以及CHD或中风家族史后,我们比较了各组的平均CRP水平。由于CRP水平可能受体重指数(BMI)影响,该模型在调整和未调整BMI的情况下均进行了拟合。
未生育女性与有血压正常妊娠史的女性之间,无论是否调整BMI,CRP水平均无显著差异(调整BMI时P = 0.82,未调整BMI时P = 0.46)。相比之下,有高血压妊娠史的女性与有血压正常妊娠史的女性相比,无论是否调整BMI,CRP水平均较高(调整BMI时P = 0.009,未调整BMI时P < 0.001)。
孕期高血压病史与晚年CRP水平升高有关,独立于传统的CVD危险因素和BMI。CRP升高可能反映了有高血压妊娠疾病史且CVD风险增加的女性的炎症状态。