Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA.
Department of Surgery, Mayo Clinic, Medical Sci Bldg 421, 200 First St SW, Rochester, MN, 55905, USA.
Curr Hypertens Rep. 2019 Nov 18;21(12):93. doi: 10.1007/s11906-019-0997-9.
Risks for developing cardiovascular disease and cognitive decline increase with age. In women, these risks may be influenced by pregnancy history. This review provides an integrated evaluation of associations of pregnancy history with hypertension, brain atrophy, and cognitive decline in postmenopausal women.
Atrophy in the occipital lobes of the brain was evident in women who had current hypertension and a history of preeclampsia. Deficits in visual memory in women with a history of preeclampsia are consistent with these brain structural changes. The blood velocity response to chemical and sympathoexcitatory stimuli were altered in women with a history of preeclampsia linking impairments in cerebrovascular regulation to the structural and functional changes in the brain. Having a history of preeclampsia should require close monitoring of blood pressure and initiation of anti-hypertensive treatment in perimenopausal women. Mechanisms by which preeclampsia affects cerebrovascular structure and function require additional study.
随着年龄的增长,患心血管疾病和认知能力下降的风险也会增加。在女性中,这些风险可能受妊娠史的影响。本综述综合评估了妊娠史与绝经后妇女的高血压、脑萎缩和认知能力下降之间的关系。
目前患有高血压和先兆子痫病史的女性大脑枕叶出现萎缩。先兆子痫病史女性的视觉记忆缺陷与这些大脑结构变化一致。先兆子痫病史女性的化学和交感神经刺激引起的血流速度反应发生改变,将脑血管调节功能障碍与大脑的结构和功能变化联系起来。有先兆子痫病史的女性应密切监测血压,并在围绝经期开始抗高血压治疗。需要进一步研究先兆子痫影响脑血管结构和功能的机制。