早发型子痫前期、晚发型子痫前期和妊娠高血压后心血管疾病风险因素
Cardiovascular disease risk factors after early-onset preeclampsia, late-onset preeclampsia, and pregnancy-induced hypertension.
作者信息
Veerbeek Jan H W, Hermes Wietske, Breimer Anath Y, van Rijn Bas B, Koenen Steven V, Mol Ben W, Franx Arie, de Groot Christianne J M, Koster Maria P H
机构信息
From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia (B.W.M.); and Academic Unit of Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, United Kingdom (B.B.v.R.).
出版信息
Hypertension. 2015 Mar;65(3):600-6. doi: 10.1161/HYPERTENSIONAHA.114.04850. Epub 2015 Jan 5.
Observational studies have shown an increased lifetime risk of cardiovascular disease (CVD) in women who experienced a hypertensive disorder in pregnancy. This risk is related to the severity of the pregnancy-related hypertensive disease and gestational age at onset. However, it has not been investigated whether these differences in CVD risk factors are already present at postpartum cardiovascular screening. We evaluated postpartum differences in CVD risk factors in 3 subgroups of patients with a history of hypertensive pregnancy. We compared the prevalence of common CVD risk factors postpartum among 448 women with previous early-onset preeclampsia, 76 women with previous late-onset preeclampsia, and 224 women with previous pregnancy-induced hypertension. Women with previous early-onset preeclampsia were compared with women with late-onset preeclampsia and pregnancy-induced hypertension and had significantly higher fasting blood glucose (5.29 versus 4.80 and 4.83 mmol/L), insulin (9.12 versus 6.31 and 6.7 uIU/L), triglycerides (1.32 versus 1.02 and 0.97 mmol/L), and total cholesterol (5.14 versus 4.73 and 4.73 mmol/L). Almost half of the early-onset preeclampsia women had developed hypertension, as opposed to 39% and 25% of women in the pregnancy-induced hypertension and late-onset preeclampsia groups, respectively. Our data show differences in the prevalence of common modifiable CVD risk factors postpartum and suggest that prevention strategies should be stratified according to severity and gestational age of onset for the hypertensive disorders of pregnancy.
观察性研究表明,孕期患有高血压疾病的女性一生中心血管疾病(CVD)风险增加。这种风险与妊娠相关高血压疾病的严重程度及发病时的孕周有关。然而,产后心血管筛查时这些心血管疾病危险因素的差异是否已然存在尚未得到研究。我们评估了有高血压妊娠史的3组患者产后心血管疾病危险因素的差异。我们比较了448例既往有早发型子痫前期、76例既往有晚发型子痫前期和224例既往有妊娠高血压的女性产后常见心血管疾病危险因素的患病率。将既往有早发型子痫前期的女性与晚发型子痫前期和妊娠高血压的女性进行比较,前者空腹血糖(5.29 vs 4.80和4.83 mmol/L)、胰岛素(9.12 vs 6.31和6.7 uIU/L)、甘油三酯(1.32 vs 1.02和0.97 mmol/L)及总胆固醇(5.14 vs 4.73和4.73 mmol/L)显著更高。几乎一半的早发型子痫前期女性已患高血压,而妊娠高血压组和晚发型子痫前期组分别为39%和25%。我们的数据显示产后常见可改变心血管疾病危险因素的患病率存在差异,并表明应根据妊娠高血压疾病的严重程度和发病孕周对预防策略进行分层。