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子痫前期与未来心血管疾病风险:评估英国临床医生的知识和实践。

Pre-eclampsia and future cardiovascular disease risk: Assessing British clinicians' knowledge and practice.

机构信息

Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, University of Manchester, United Kingdom.

Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, University of Manchester, United Kingdom; St Mary's Hospital, Manchester University NHS Foundation Trust, United Kingdom.

出版信息

Pregnancy Hypertens. 2024 Sep;37:101145. doi: 10.1016/j.preghy.2024.101145. Epub 2024 Aug 10.

Abstract

OBJECTIVE

To explore UK-based clinicians' knowledge of long-term cardiovascular disease (CVD) risks after pre-eclampsia and capture current risk management practice.

STUDY DESIGN

A voluntary online survey was designed to explore clinicians' perception and management of CVD risks after pre-eclampsia. Distribution occurred May-July 2022 via social media and email. The survey assessed awareness of pre-eclampsia's association with future CVD, knowledge of published guidelines on CVD risk management after pre-eclampsia, and current practice of risk-reduction counselling. Results were analysed descriptively.

MAIN OUTCOME MEASURE

Clinician knowledge of postpartum cardiovascular risk and management following pre-eclampsia.

RESULTS

Of 240 respondents, 72 were midwives, 46 obstetricians, 8 cardiologists, and 114 general practitioners (GPs). Most clinicians knew that pre-eclampsia increases the risk of chronic hypertension (89 %) and stroke (75 %). Awareness was worse for heart failure (47 %) and peripheral vascular disease (55 %). Obstetricians provide CVD risk-reduction counselling to women with pre-eclampsia most frequently: 43 % always counsel and 27 % often counsel. Most other clinicians never counsel patients (midwives: 76 %, cardiologists: 75 %, GPs: 62 %). Most clinicians (84 %) were not aware of CVD risk management guidance after pre-eclampsia and 75 % of cardiologists and GPs never consider pre-eclampsia when assessing cardiovascular risk. Almost all clinicians (91 %) wished for greater education on the topic.

CONCLUSIONS

This study presents the first assessment of cardiovascular risk awareness after pre-eclampsia amongst UK-based clinicians. Although most knew pre-eclampsia increases CVD risk, patient counselling was limited. Targeted educational initiatives are needed to improve the knowledge-to-practice gap and reduce CVD prevalence after pre-eclampsia.

摘要

目的

探索英国临床医生对先兆子痫后长期心血管疾病 (CVD) 风险的认知,并了解当前的风险管理实践。

研究设计

本研究通过自愿在线调查,探索了临床医生对先兆子痫后 CVD 风险的认知和管理。该调查于 2022 年 5 月至 7 月通过社交媒体和电子邮件进行。该调查评估了对先兆子痫与未来 CVD 之间关联的认识、对先兆子痫后 CVD 风险管理指南的了解,以及风险降低咨询的当前实践。结果进行了描述性分析。

主要观察指标

产后心血管风险和先兆子痫后管理的临床医生知识。

结果

在 240 名受访者中,72 人是助产士,46 人是产科医生,8 人是心脏病专家,114 人是全科医生。大多数临床医生知道先兆子痫会增加慢性高血压(89%)和中风(75%)的风险。对心力衰竭(47%)和外周血管疾病(55%)的认识较差。产科医生最常为患有先兆子痫的女性提供 CVD 风险降低咨询:43%的医生总是咨询,27%的医生经常咨询。大多数其他临床医生从不向患者提供咨询(助产士:76%,心脏病专家:75%,全科医生:62%)。大多数临床医生(84%)不知道先兆子痫后的 CVD 风险管理指南,75%的心脏病专家和全科医生在评估心血管风险时从不考虑先兆子痫。几乎所有的临床医生(91%)都希望在这个话题上接受更多的教育。

结论

本研究首次评估了英国临床医生对先兆子痫后 CVD 风险的认知。尽管大多数人都知道先兆子痫会增加 CVD 风险,但患者咨询却很有限。需要有针对性的教育举措,以缩小知识与实践之间的差距,降低先兆子痫后的 CVD 发生率。

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