Cardiology Department, Faculty of medicine, Beni-Suef University, Beni-Suef, Egypt.
Cardiology Department, Faculty of medicine, Beni-Suef University, Beni-Suef, Egypt.
Hipertens Riesgo Vasc. 2021 Apr-Jun;38(2):56-62. doi: 10.1016/j.hipert.2020.09.003. Epub 2020 Oct 21.
Hypertensive pregnancy was recognized as a risk factor of cardiovascular events. The aim of our study was to evaluate the short-term cardiovascular risk in normotensive females with previous hypertensive pregnancy.
A prospective cohort study was conducted on 50 females with previous normotensive pregnancy and 50 females with previous hypertensive pregnancy. All patients were re-evaluated three months postpartum to be sure that they became normotensive. One year postpartum, all patients were subjected to renal function tests, urinary albumin/creatinine ratio for microalbuminuria, glycated hemoglobin, complete lipid profile, echocardiographic assessment of left ventricular mass index and carotid duplex for measurement of intimal-medial thickness, presence of carotid plaques and stenosis.
No significant difference between both groups regarding blood pressure level three months postpartum. No significant difference between both groups regarding serum creatinine. Patients with previous hypertensive pregnancy group had significantly higher microalbuminuria compared with previous normotensive pregnancy group (p=0.000). Serum LDL and triglycerides were significantly higher however HDL was significantly lower in those with previous hypertensive pregnancy, however all lipid profile measures were within normal range. No significant difference between both groups regarding left ventricular mass index and carotid intima-media thickness. No evidence of carotid plaques or stenosis in both groups.
Previous hypertensive pregnancy was associated with increased risk of microalbuminuria at short term level even after normalization of blood pressure post-partum. Longer period of follow up is required to establish the potential cardiovascular risk in these patients.
高血压妊娠被认为是心血管事件的危险因素。我们的研究目的是评估既往正常血压妊娠的女性中短期心血管风险。
对 50 例既往正常血压妊娠和 50 例既往高血压妊娠的女性进行前瞻性队列研究。所有患者均在产后 3 个月再次评估以确保其血压正常。产后 1 年，所有患者均进行肾功能检查、尿白蛋白/肌酐比值检测微量白蛋白尿、糖化血红蛋白、完整血脂谱、左心室质量指数超声心动图评估和颈动脉双功能超声检查以测量内膜中层厚度、颈动脉斑块和狭窄的存在。
两组患者产后 3 个月血压水平无显著差异。两组患者的血清肌酐无显著差异。既往高血压妊娠组的微量白蛋白尿明显高于既往正常血压妊娠组（p=0.000）。然而，既往高血压妊娠组的血清 LDL 和甘油三酯明显升高，而 HDL 明显降低，但所有血脂谱指标均在正常范围内。两组患者的左心室质量指数和颈动脉内膜中层厚度无显著差异。两组均无颈动脉斑块或狭窄的证据。
即使产后血压正常，既往高血压妊娠与短期微量白蛋白尿风险增加相关。需要更长的随访时间来确定这些患者的潜在心血管风险。
