Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada; Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.
Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada; Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; Department of Obstetrics & Gynecology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
J Clin Lipidol. 2019 Nov-Dec;13(6):1008-1015. doi: 10.1016/j.jacl.2019.10.002. Epub 2019 Oct 12.
The hypertensive disorders of pregnancy (HDP), including preeclampsia (PE) and gestational hypertension (GHTN), are independent risk factors for future maternal cardiovascular disease. Epidemiologic evidence has demonstrated that women with HDP have abnormal cardiovascular risk factors in the early postpartum period, but this has not been fully characterized.
This study aimed to assess the lipid profiles among women with PE, GHTN, and normal blood pressure in the first 4 years postpartum.
Discharge Abstract Database was used to identify women hospitalized for a delivery in Calgary, Alberta, Canada, between January 2010 and December 2012 (N = 27,300). This was linked with Calgary Laboratory Services (for lipid levels) and the Pharmaceutical Information Network database (for lipid medication prescriptions) over the first 4 years postpartum (2010-2016). Logistic regression analysis was used to compare the frequency of lipid tests among HDP subtypes, adjusted for maternal age, gestational age at delivery, and parity.
Only about half of the women with HDP had a lipid test in the first 4 years postpartum: 50.8% (PE) and 48.8% (GHTN) vs 41.5% in normotensive women (P < .001). Low-density lipoprotein cholesterol levels were significantly higher in women with HDP: 106.3 ± 35.2 mg/dL (2.75 ± 0.91 mmol/L) in PE, 102.5 ± 30.5 mg/dL (2.65 ± 0.79 mmol/L) in GHTN, and 96.7 ± 29.0 mg/dL (2.50 ± 0.75 mmol/L) in normotensive women (P < .001).
Postpartum lipid screening helps identify women at risk of cardiovascular disease; however, only 50% of women with HDP were tested in the first years postpartum. As such, an early opportunity for primary CVD prevention strategies in young women may be lost.
妊娠高血压疾病（HDP），包括子痫前期（PE）和妊娠期高血压（GHTN），是未来发生母亲心血管疾病的独立危险因素。流行病学证据表明，患有 HDP 的女性在产后早期即存在心血管危险因素异常，但这尚未得到充分描述。
本研究旨在评估产后 4 年内患有 PE、GHTN 和正常血压的女性的血脂谱。
使用卡尔加里分娩住院患者的出院摘要数据库（2010 年 1 月至 2012 年 12 月，共 27300 例），并在产后 4 年内（2010-2016 年）与卡尔加里实验室服务（用于血脂水平）和药物信息网络数据库（用于血脂药物处方）进行链接。采用 logistic 回归分析比较 HDP 各亚型之间血脂检查的频率，调整了产妇年龄、分娩时的孕龄和产次。
仅有约一半的 HDP 女性在产后 4 年内进行了血脂检查：PE 组为 50.8%（50.8%），GHTN 组为 48.8%（48.8%），而正常血压女性组为 41.5%（P<.001）。HDP 女性的低密度脂蛋白胆固醇水平明显较高：PE 组为 106.3±35.2mg/dL（2.75±0.91mmol/L），GHTN 组为 102.5±30.5mg/dL（2.65±0.79mmol/L），正常血压女性组为 96.7±29.0mg/dL（2.50±0.75mmol/L）（P<.001）。
产后血脂筛查有助于识别发生心血管疾病的风险女性；然而，仅有 50%的 HDP 女性在产后 1 年内接受了检查。因此，年轻女性的心血管疾病一级预防策略可能会错失早期机会。
