Nilsson Peter M, Viigimaa Margus, Giwercman Aleksander, Cifkova Renata
Department of Clinical Sciences, Lund University, Lund, Sweden.
Skåne University Hospital, Malmö, Sweden.
Curr Hypertens Rep. 2020 Mar 13;22(4):29. doi: 10.1007/s11906-020-01036-2.
Many aspects of reproduction have been associated with increased blood pressure and impaired glucose metabolism that reveals a subsequent increased risk of cardiovascular disease. The aim of this review is to assess reproductive life factors associated with an increased risk of hypertension and cardiovascular disease, e.g., early life programming, sexual, and reproductive health in men and women.
Impaired fetal growth, with low birth weight adjusted for gestational age, has been found associated with hypertension in adulthood. Erectile dysfunction, currently considered an early diagnostic marker of cardiovascular disease preceding the manifestation of coronary artery disease by several years, frequently coexisting with hypertension, could also be exacerbated by some antihypertensive drugs. Male hypogonadism or subfertility are associated with increased cardiovascular risk. Hypertensive disorders in pregnancy including preeclampsia represent a major cause of maternal, fetal and neonatal morbidity, and mortality. The risk of developing preeclampsia can be substantially reduced in women at its high or moderate risk with a low dose of acetylsalicylic acid initiated from 12 weeks of gestation. An increased risk of hypertension in women following invasive-assisted reproductive technologies has been newly observed. Blood pressure elevation has been noticed following contraceptive pill use, around the menopause and in postmenopausal age. Furthermore, drug treatment of hypertension has to be considered as a factor with a potential impact on reproduction (e.g., due to teratogenic drug effects). In summary, a deeper understanding of reproductive life effects on hypertension and metabolic abnormalities may improve prediction of future cardiovascular disease.
生殖的许多方面都与血压升高和糖代谢受损有关，这揭示了随后心血管疾病风险的增加。本综述的目的是评估与高血压和心血管疾病风险增加相关的生殖生活因素，例如早期生活编程、男性和女性的性健康与生殖健康。
已发现胎儿生长受限（根据胎龄调整后的低出生体重）与成年期高血压有关。勃起功能障碍目前被认为是心血管疾病的早期诊断标志物，比冠状动脉疾病的表现早数年出现，且常与高血压并存，某些抗高血压药物也可能使其加重。男性性腺功能减退或生育力低下与心血管风险增加有关。包括先兆子痫在内的妊娠期高血压疾病是孕产妇、胎儿和新生儿发病和死亡的主要原因。对于高风险或中度风险的女性，从妊娠12周开始使用低剂量乙酰水杨酸可大幅降低患先兆子痫的风险。最近观察到，接受侵入性辅助生殖技术的女性患高血压的风险增加。在使用避孕药丸后、绝经前后以及绝经后年龄阶段，血压都会升高。此外，必须将高血压的药物治疗视为对生殖有潜在影响的一个因素（例如，由于药物的致畸作用）。总之，更深入地了解生殖生活对高血压和代谢异常的影响可能会改善对未来心血管疾病的预测。
