Hypertension in pregnancy and risk of coronary heart disease and stroke: A prospective study in a large UK cohort
Hypertension in pregnancy and risk of coronary heart disease and stroke: A prospective study in a large UK cohort
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DOI：
10.1016/j.ijcard.2016.07.170
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发表时间：
2016-11-01
影响因子：
3.5
通讯作者：
Reeves, Gillian
中科院分区：
文献类型：
--
作者：
Canoy, Dexter;Cairns, Benjamin J.;Reeves, Gillian
背景资料：许多研究调查了与妊娠高血压相关的长期血管疾病风险，研究了相对年轻的女性的风险，其中血管疾病是罕见的。我们研究了高血压的历史在怀孕期间和冠心病（CHD）和中风的中年英国women.Methods：在1996年至2001年，110万产妇（平均年龄= 56岁）没有血管疾病的基线报告他们的高血压的历史在怀孕期间和其他因素之间的前瞻性关系。对他们的CHD和卒中事件（住院或死亡）进行随访。调整后的相对危险度（RR）计算使用考克斯regression.Results：百分之二十六（290，008/110万）报告有高血压妊娠; 27%（79，163/290，008）的妇女与高血压妊娠，但只有10%（82，145/815，560）的那些没有高血压妊娠，报告正在治疗高血压在基线。平均随访时间为11.6年（诊断时的平均年龄/事件数量：CHD = 65岁/N = 68，161，缺血性卒中= 67岁/N = 8365，出血性卒中= 64岁/N = 5702）。总体而言，妊娠期高血压女性与无妊娠期高血压病史女性相比，发生疾病的RR（95%置信区间[CI]）为：CHD = 1.29（1.27-1.31），缺血性卒中= 1.29（1.23-1.35），出血性卒中= 1.14（1.07-1.21）。然而，在基线时未接受高血压治疗的妊娠高血压妇女中，其RR（95% CI）仅适度增加：CHD = 1.17（1.14-1.19），缺血性卒中= 1.18（1.11-1.25），出血性卒中= 1.09（1.02-1.18）.结论：妊娠期高血压与中年冠心病和中风发病率增加有关，这主要是因为这些妇女在50多岁和60多岁时也患有高血压，这对血管疾病风险的影响远远大于怀孕期间的高血压，而在以后的生活中没有高血压。(C)2016年6月，作者。由爱思唯尔爱尔兰有限公司出版
Background: Many studies investigating long-term vascular disease risk associated with hypertensive pregnancies examined risks in relatively young women among whom vascular disease is uncommon. We examined the prospective relation between a history of hypertension during pregnancy and coronary heart disease (CHD) and stroke in middle-aged UK women.Methods: In 1996-2001, 1.1 million parous women (mean age = 56 years) without vascular disease at baseline reported their history of hypertension during pregnancy and other factors. They were followed for incident CHD and stroke (hospitalisation or death). Adjusted relative risks (RRs) were calculated using Cox regression.Results: Twenty-six percent (290,008/1.1 million) reported having had a hypertensive pregnancy; 27% (79,163/290,008) of women with hypertensive pregnancy, but only 10% (82,145/815,560) of those without hypertensive pregnancy, reported being treated for hypertension at baseline. Mean follow-up was 11.6 years (mean ages at diagnosis/N of events: CHD = 65 years/N = 68,161, ischaemic stroke = 67 years/N = 8365, haemorrhagic stroke = 64 years/N = 5702). Overall, the RRs (95% confidence interval [CI]) of incident disease in women with hypertensive pregnancy versus those without such history were: CHD = 1.29 (1.27-1.31), ischaemic stroke = 1.29 (1.23-1.35), and haemorrhagic stroke = 1.14 (1.07-1.21). However, among women with hypertensive pregnancy who were not taking hypertension treatment at baseline, their RRs (95% CI) were only modestly increased: CHD = 1.17 (1.14-1.19), ischaemic stroke = 1.18 (1.11-1.25), and haemorrhagic stroke = 1.09 (1.02-1.18).Conclusion: Hypertension during pregnancy was associated with increased CHD and stroke incidence in middle age, largely because such women also had hypertension in their 50s and 60s, which has a substantially greater effect on vascular disease risk than hypertension during pregnancy without hypertension later in life. (C) 2016 The Authors. Published by Elsevier Ireland Ltd.