Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy.
IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy.
Eur Heart J Qual Care Clin Outcomes. 2024 Jan 12;10(1):4-13. doi: 10.1093/ehjqcco/qcad065.
BACKGROUND/INTRODUCTION: There is a need for further studies on the cardiovascular risk of women experiencing pre-eclampsia (PE).
To update the literature regarding the association between a history of PE and subsequent cardiovascular diseases, including cardiovascular death, coronary heart diseases, heart failure, and stroke, focusing on the trend in the effect size (ES) estimates over time.
Following PRISMA guidelines, from inception to May 2023, we performed a systematic review of PubMed, MEDLINE, Scopus, and EMBASE. Randomized, cohort, or case-control studies in English were included if fulfiling the following criteria:(i) The association between PE and subsequent cardiovascular disease was adjusted for clinically relevant variables, (ii) the presence of a control group, and (iii) at least 1 year of follow-up. Pooled adjusted ESs and 95% confidence intervals (CIs) were used as effect estimates and calculated with a random-effect model. Twenty-two studies met the inclusion criteria. PE was associated with a higher risk of cardiovascular death (ES 2.08, 95% CI 1.70-2.54, I2 56%, P < 0.00001), coronary artery diseases (ES 2.04, 95% CI 1.76-2.38, I2 87%, P < 0.00001), heart failure (ES 2.47, 95% CI 1.89-3.22, I2 83%, P < 0.00001), and stroke (ES 1.75, 95% CI 1.52-2.02, I2 72%, P < 0.00001) after adjusting for potential confounders. This risk is evident in the first 1-to-3 years of follow-up and remains significant until 39 years of follow-up.
Compared to women who experienced a normal pregnancy, those suffering from PE have about double the risk of lifetime cardiovascular disease.
背景/引言：需要进一步研究经历子痫前期 (PE) 的女性的心血管风险。
更新关于 PE 病史与随后心血管疾病（包括心血管死亡、冠心病、心力衰竭和中风）之间关联的文献，重点关注随着时间推移，效应大小 (ES) 估计值的趋势。
根据 PRISMA 指南，从创建到 2023 年 5 月，我们对 PubMed、MEDLINE、Scopus 和 EMBASE 进行了系统评价。如果符合以下标准，包括随机、队列或病例对照研究在内的英文研究将被纳入：(i) PE 与随后心血管疾病的关联经过临床相关变量调整，(ii) 存在对照组，以及 (iii) 至少 1 年的随访。使用随机效应模型计算汇总调整后的 ES 和 95%置信区间 (CI) 作为效应估计值。22 项研究符合纳入标准。PE 与心血管死亡风险升高相关（ES 2.08，95%CI 1.70-2.54，I2 56%，P<0.00001）、冠心病（ES 2.04，95%CI 1.76-2.38，I2 87%，P<0.00001）、心力衰竭（ES 2.47，95%CI 1.89-3.22，I2 83%，P<0.00001）和中风（ES 1.75，95%CI 1.52-2.02，I2 72%，P<0.00001），调整潜在混杂因素后。这种风险在随访的头 1 至 3 年内明显，并且一直持续到随访 39 年。
与经历正常妊娠的女性相比，患有 PE 的女性一生中患心血管疾病的风险大约增加一倍。
