Lind Joanne M, Hennessy Annemarie, McLean Mark
University of Western Sydney, School of Medicine, NSW, Australia.
Curr Opin Cardiol. 2014 Sep;29(5):447-53. doi: 10.1097/HCO.0000000000000094.
Cardiovascular disease (CVD) remains the major killer of women around the globe. Complications during pregnancy, including hypertensive disorders of pregnancy and gestational diabetes mellitus, are now recognized as risk factors for future CVD.
Studies of diverse populations demonstrate the links between these complications of pregnancy and a woman's future risk of CVD including atherosclerosis, hypertension, stroke, coronary artery disease, and heart failure. Markers that persist in these women following pregnancy continue to be identified and include microalbuminuria, proteinuria, elevated homocysteine levels, C-reactive protein, and salt sensitivity. Efforts are now being placed on establishing specialized clinics to monitor women beyond pregnancy to help reduce the burden of future disease.
Pregnancy offers a unique window through which women at risk of future CVD may be identified. Clinicians have an opportunity to implement health monitoring, lifestyle modifications, and other interventions during this period, and beyond, that will help reduce the burden of CVD. Research should continue to focus on identifying and understanding the mechanisms that lead to future CVD in these women; deciphering whether pregnancy unmasks an existing predisposition to disease, compounds the risk of future disease, or is the direct cause of future disease.
心血管疾病（CVD）仍是全球女性的主要杀手。孕期并发症，包括妊娠期高血压疾病和妊娠期糖尿病，现已被确认为未来发生CVD的危险因素。
对不同人群的研究表明，这些孕期并发症与女性未来发生CVD的风险之间存在联系，包括动脉粥样硬化、高血压、中风、冠状动脉疾病和心力衰竭。孕期后在这些女性中持续存在的标志物不断被发现，包括微量白蛋白尿、蛋白尿、同型半胱氨酸水平升高、C反应蛋白和盐敏感性。目前正在努力建立专门诊所，对产后女性进行监测，以帮助减轻未来疾病的负担。
孕期提供了一个独特的窗口，通过这个窗口可以识别未来有患CVD风险的女性。临床医生有机会在此期间及之后实施健康监测、生活方式改变和其他干预措施，这将有助于减轻CVD的负担。研究应继续侧重于识别和理解导致这些女性未来发生CVD的机制；解读孕期是揭示了现有的疾病易感性、增加了未来疾病的风险，还是未来疾病的直接原因。
