Weissgerber Tracey L, Turner Stephen T, Mosley Thomas H, Kardia Sharon L R, Hanis Craig L, Milic Natasa M, Garovic Vesna D
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota;
University of Mississippi Medical Center, Jackson, Mississippi;
J Am Soc Nephrol. 2016 Mar;27(3):894-902. doi: 10.1681/ASN.2015010086. Epub 2015 Aug 27.
Hypertension in pregnancy is a risk factor for future hypertension and cardiovascular disease. This may reflect an underlying familial predisposition or persistent damage caused by the hypertensive pregnancy. We sought to isolate the effect of hypertension in pregnancy by comparing the risk of hypertension and cardiovascular disease in women who had hypertension in pregnancy and their sisters who did not using the dataset from the Genetic Epidemiology Network of Arteriopathy study, which examined the genetics of hypertension in white, black, and Hispanic siblings. This analysis included all sibships with at least one parous woman and at least one other sibling. After gathering demographic and pregnancy data, BP and serum analytes were measured. Disease-free survival was examined using Kaplan-Meier curves and Cox proportional hazards regression. Compared with their sisters who did not have hypertension in pregnancy, women who had hypertension in pregnancy were more likely to develop new onset hypertension later in life, after adjusting for body mass index and diabetes (hazard ratio 1.75, 95% confidence interval 1.27-2.42). A sibling history of hypertension in pregnancy was also associated with an increased risk of hypertension in brothers and unaffected sisters, whereas an increased risk of cardiovascular events was observed in brothers only. These results suggest familial factors contribute to the increased risk of future hypertension in women who had hypertension in pregnancy. Further studies are needed to clarify the potential role of nonfamilial factors. Furthermore, a sibling history of hypertension in pregnancy may be a novel familial risk factor for future hypertension.
妊娠期高血压是未来发生高血压和心血管疾病的一个危险因素。这可能反映了潜在的家族易感性或妊娠期高血压所致的持续性损害。我们试图通过比较妊娠期患高血压的女性及其未患高血压的姐妹发生高血压和心血管疾病的风险，利用动脉病遗传流行病学网络研究的数据来分离妊娠期高血压的影响，该研究调查了白人、黑人和西班牙裔兄弟姐妹的高血压遗传学。这项分析纳入了所有至少有一名经产妇和至少一名其他兄弟姐妹的同胞关系。收集人口统计学和妊娠数据后，测量血压和血清分析物。使用Kaplan-Meier曲线和Cox比例风险回归分析无病生存率。在调整体重指数和糖尿病因素后，与妊娠期未患高血压的姐妹相比，妊娠期患高血压的女性在以后的生活中更有可能发生新发高血压（风险比1.75，95%置信区间1.27-2.42）。妊娠期高血压的同胞病史也与兄弟和未受影响姐妹患高血压的风险增加有关，而仅在兄弟中观察到心血管事件风险增加。这些结果表明，家族因素导致妊娠期患高血压的女性未来患高血压的风险增加。需要进一步研究以阐明非家族因素的潜在作用。此外，妊娠期高血压的同胞病史可能是未来高血压的一个新的家族风险因素。
