Faculty of Health and Medicine University of Newcastle New South Wales Australia.
Liverpool Hospital Liverpool New South Wales Australia.
J Am Heart Assoc. 2020 Jul 7;9(13):e013991. doi: 10.1161/JAHA.119.013991. Epub 2020 Jun 24.
Background Inconsistent findings have been found among studies evaluating the risk of cardiovascular disease for women who have had pregnancies complicated by gestational hypertension (the new onset of high blood pressure without proteinuria during pregnancy). We provide a comprehensive review of studies to quantify the association between gestational hypertension and cardiovascular events in women. Methods and Results We conducted a systematic search of PubMed, Embase, and Web of Science in March 2019 for studies examining the association between gestational hypertension and any cardiovascular event. Two reviewers independently assessed the abstracts and full-text articles. Study characteristics and the relative risk (RR) of cardiovascular events associated with gestational hypertension were extracted from the eligible studies. Where appropriate, the estimates were pooled with inverse variance weighted random-effects meta-analysis. A total of 21 studies involving 3 60 1192 women (127 913 with gestational hypertension) were identified. Gestational hypertension in the first pregnancy was associated with a greater risk of overall cardiovascular disease (RR, 1.45; 95% CI, 1.17-1.80) and coronary heart disease (RR, 1.46; 95% CI, 1.23-1.73), but not stroke (RR, 1.26; 95% CI, 0.96-1.65) or thromboembolic events (RR, 0.88; 95% CI, 0.73-1.07). Women with 1 or more pregnancies affected by gestational hypertension were at greater risk of cardiovascular disease (RR, 1.81; 95% CI, 1.42-2.31), coronary heart disease (RR, 1.83; 95% CI, 1.33-2.51), and heart failure (RR, 1.77; 95% CI, 1.47-2.13), but not stroke (RR, 1.50; 95% CI, 0.75-2.99). Conclusions Gestational hypertension is associated with a greater risk of overall cardiovascular disease, coronary heart disease, and heart failure. More research is needed to assess the presence of a dose-response relationship between gestational hypertension and subsequent cardiovascular disease. Registration URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42018119031.
评估妊娠高血压（怀孕期间无蛋白尿但血压升高）孕妇发生心血管疾病风险的研究结果并不一致。我们对研究进行了全面综述，以量化妊娠高血压与女性心血管事件之间的关联。
我们于 2019 年 3 月在 PubMed、Embase 和 Web of Science 中进行了系统检索，以检索评估妊娠高血压与任何心血管事件之间关联的研究。两名评审员独立评估摘要和全文文章。从合格研究中提取与妊娠高血压相关的心血管事件的相对风险（RR）和研究特征。在适当的情况下，采用倒数方差加权随机效应荟萃分析对估计值进行合并。共纳入 21 项研究，涉及 3601192 名女性（127913 名患有妊娠高血压）。首次妊娠时发生妊娠高血压与整体心血管疾病（RR，1.45；95%CI，1.17-1.80）和冠心病（RR，1.46；95%CI，1.23-1.73）风险增加相关，但与中风（RR，1.26；95%CI，0.96-1.65）或血栓栓塞事件（RR，0.88；95%CI，0.73-1.07）无关。患有 1 次或多次妊娠合并妊娠高血压的女性发生心血管疾病（RR，1.81；95%CI，1.42-2.31）、冠心病（RR，1.83；95%CI，1.33-2.51）和心力衰竭（RR，1.77；95%CI，1.47-2.13）的风险更高，但中风（RR，1.50；95%CI，0.75-2.99）风险没有增加。
妊娠高血压与整体心血管疾病、冠心病和心力衰竭的风险增加相关。需要进一步研究评估妊娠高血压与随后发生的心血管疾病之间是否存在剂量-反应关系。
