Christensen Martin, Kronborg Camilla Skovhus, Eldrup Nikolaj, Rossen Niklas Blach, Knudsen Ulla Breth
Clinical Research Unit, Randers Regional Hospital, Skovlyvej 1, 8930 Randers NO, Denmark; Institute of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark.
Department of Oncology, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C, Denmark.
Pregnancy Hypertens. 2016 Apr;6(2):110-4. doi: 10.1016/j.preghy.2016.04.001. Epub 2016 Apr 9.
Epidemiological studies associate preeclampsia with increased risk of premature cardiovascular disease (CVD) later in life. This study aims to make a comprehensive CVD risk assessment comparing women with previous preeclamptic pregnancies to women with previous normotensive pregnancies 10years after index pregnancy.
A nested, matched, observational cohort study.
Markers of arterial stiffness, aortic pulse wave velocity (aPWV) and augmentation index (AIx-75), and markers of atherosclerosis, carotid intima-media thickness (cIMT) and carotid plaque presence. Traditional CVD risk factors and 10-year and 30-year Framingham CVD risk scores were also assessed.
Women were included from April 2014 to October 2014 at a tertiary referral hospital in Denmark. Twenty-one exposed women with a history of preeclampsia and 21 unexposed with a history of normotensive pregnancies were included. Ten years after delivery, significantly more exposed women suffered from hypertension and received antihypertensive treatment and significantly more fulfilled the hypertension-definition at screening. Previously preeclamptic women also tended to have more unfavorable CVD risk estimates. The Framingham risk scores seemed to extend the unfavorable CVD risk. The exposed women tended to have a higher aPWV compared to unexposed women, (P=0.057). No differences were shown in the other examined arteriosclerotic or atherosclerotic variables.
Ten years after delivery, we found increased risk of hypertension and trend toward unfavorable CVD risk profile in 40-year-old previously preeclamptic women. However, arterial stiffness and atherosclerosis did not uncover any additional CVD risk information at this time point.
流行病学研究表明，子痫前期与日后发生心血管疾病（CVD）的风险增加有关。本研究旨在进行全面的CVD风险评估，比较有子痫前期妊娠史的女性与血压正常妊娠史的女性在本次妊娠10年后的情况。
一项嵌套、匹配的观察性队列研究。
动脉僵硬度标志物、主动脉脉搏波速度（aPWV）和增强指数（AIx-75），以及动脉粥样硬化标志物、颈动脉内膜中层厚度（cIMT）和颈动脉斑块的存在情况。还评估了传统的CVD危险因素以及10年和30年的弗雷明汉CVD风险评分。
2014年4月至2014年10月期间，丹麦一家三级转诊医院纳入了研究对象。纳入了21名有子痫前期病史的暴露组女性和21名有血压正常妊娠史的非暴露组女性。分娩10年后，暴露组中患高血压并接受降压治疗的女性明显更多，且在筛查时符合高血压定义的女性也明显更多。有子痫前期病史的女性在CVD风险评估方面也往往更不利。弗雷明汉风险评分似乎扩大了不利的CVD风险。与非暴露组女性相比，暴露组女性的aPWV往往更高（P=0.057）。在其他检查的动脉硬化或动脉粥样硬化变量中未显示出差异。
分娩10年后，我们发现有子痫前期病史的40岁女性患高血压的风险增加，且CVD风险状况有不利趋势。然而，在这个时间点，动脉僵硬度和动脉粥样硬化并未发现任何额外的CVD风险信息。
