Division of Maternal Medicine, Center for Maternal-Fetal-Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Hypertens Res. 2018 Feb;41(2):141-146. doi: 10.1038/hr.2017.100. Epub 2017 Nov 2.
Hypertensive disorders of pregnancy are known to be a risk factor for future cardiovascular diseases. In contrast, there is a paucity of data on the not so distant future prognosis of hypertensive disorders of pregnancy. In the present study, we evaluated the incidence of the diseases causing cardiovascular problems (hypertension, diabetes mellitus, dyslipidemia and metabolic syndrome) 5 years after delivery in Japanese women with hypertensive disorders of pregnancy. We performed a double-cohort study and compared medical conditions between women with and without a history of hypertensive disorders of pregnancy. A total of 1513 women who participated in the cohort study were invited to undergo a medical checkup 5 years after the index delivery, of whom 829 responded. After excluding pregnant and lactating women at the time of examination, 25 women with hypertensive disorders of pregnancy and 746 control subjects were analyzed. The incidence of hypertension was significantly higher among women with hypertensive disorders of pregnancy than women who were normotensive during pregnancy (24.0 vs. 2.5%, P<0.001). They were also at an increased risk of subsequent hypertension 5 years after the index delivery, after adjusting for confounding factors such as age, body mass index, family history of hypertension and salt intake (odds ratio 7.1, 95% CI, 2.0-25.6, P<0.003). These is no significant difference in the incidence of diabetes mellitus, dyslipidemia and metabolic syndrome. In conclusion, hypertensive disorders of pregnancy are strong risk factors for subsequent hypertension only 5 years after delivery.
妊娠高血压疾病已知是未来心血管疾病的危险因素。相比之下,关于妊娠高血压疾病近期预后的数据却很少。在本研究中,我们评估了日本妊娠高血压疾病女性在分娩后 5 年内发生心血管问题(高血压、糖尿病、血脂异常和代谢综合征)的发病率。我们进行了一项双队列研究,并比较了有和无妊娠高血压疾病史的女性的医疗状况。共有 1513 名参加队列研究的女性受邀在指数分娩后 5 年进行体检,其中 829 人回应。在排除检查时怀孕和哺乳期的女性后,对 25 名妊娠高血压疾病患者和 746 名对照者进行了分析。与妊娠期间血压正常的女性相比,妊娠高血压疾病患者的高血压发病率显著更高(24.0% vs. 2.5%,P<0.001)。在校正年龄、体重指数、高血压家族史和盐摄入量等混杂因素后,她们在指数分娩后 5 年内发生后续高血压的风险也增加(优势比 7.1,95%CI,2.0-25.6,P<0.003)。糖尿病、血脂异常和代谢综合征的发病率没有显著差异。总之,妊娠高血压疾病是分娩后仅 5 年内发生后续高血压的强危险因素。