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妊娠高血压疾病所致的后续高血压和高血压病:东北医学大数据库项目出生及三代队列研究

Subsequent high blood pressure and hypertension by hypertensive disorders of pregnancy: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.

作者信息

Ishikuro Mami, Obara Taku, Hasegawa Mayu, Murakami Keiko, Ueno Fumihiko, Noda Aoi, Onuma Tomomi, Matsuzaki Fumiko, Iwama Noriyuki, Kikuya Masahiro, Sugawara Junichi, Azegami Tatsuhiko, Nakayama Takashin, Mito Asako, Arata Naoko, Metoki Hirohito, Kanda Takeshi, Kuriyama Shinichi

机构信息

Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.

Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

出版信息

Hypertens Res. 2025 Jan;48(1):68-76. doi: 10.1038/s41440-024-01936-9. Epub 2024 Oct 11.

Abstract

Hypertensive disorders of pregnancy can cause hypertension in the future. Understanding how the blood pressure values of women with and without hypertensive disorders of pregnancy differ will facilitate follow-up blood pressure monitoring in clinical settings. This study investigated the association between hypertensive disorders of pregnancy and subsequent high blood pressure and hypertension. This study used Japanese data from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Follow-up systolic and diastolic blood pressures in normotensive women during pregnancy and those with hypertensive disorders of pregnancy were estimated using analysis of covariance adjusted for women with low birthweight, history of gestational diabetes mellitus, age, body mass index, pulse rate, smoking and drinking at the follow-up assessment, paternal hypertension history, and maternal hypertension or hypertensive disorders of pregnancy history. Finally, we performed a multiple logistic regression analysis. In total, 7343 women were included in the analysis. Women with a history of hypertensive disorders of pregnancy had higher blood pressure approximately three years postpartum compared with normotensive women. Hypertensive disorders of pregnancy in the most recent pregnancy in different subgroups, such as nulliparous women, multiparous women without a history of hypertensive disorders of pregnancy, and multiparous women with a history of hypertensive disorders of pregnancy, were associated with an increased risk of subsequent hypertension. Women's birthweight was also weakly associated with hypertension. Even one experience of hypertensive disorders of pregnancy may contribute to elevated blood pressure and hypertension approximately three years postpartum. In addition, women's birthweights may have a weak relationship with increasing blood pressure.

摘要

妊娠高血压疾病可导致未来高血压。了解患有和未患有妊娠高血压疾病的女性的血压值差异,将有助于临床环境中的后续血压监测。本研究调查了妊娠高血压疾病与随后的高血压之间的关联。本研究使用了来自东北医学大数据库项目出生及三代队列研究的日本数据。对于出生体重低、有妊娠期糖尿病史、年龄、体重指数、脉搏率、随访评估时的吸烟和饮酒情况、父亲高血压病史以及母亲高血压或妊娠高血压疾病史的女性,采用协方差分析来估计妊娠期间血压正常的女性和患有妊娠高血压疾病的女性的随访收缩压和舒张压。最后,我们进行了多元逻辑回归分析。总共有7343名女性纳入分析。与血压正常的女性相比,有妊娠高血压疾病史的女性在产后约三年时血压更高。不同亚组(如初产妇、无妊娠高血压疾病史的经产妇以及有妊娠高血压疾病史的经产妇)最近一次妊娠中的妊娠高血压疾病与随后发生高血压的风险增加有关。女性的出生体重也与高血压存在弱关联。即使有一次妊娠高血压疾病经历也可能导致产后约三年时血压升高和患高血压。此外,女性的出生体重可能与血压升高存在微弱关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11700841/3f7038ee7d93/41440_2024_1936_Fig1_HTML.jpg

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