Pregnancy hypertensive disease and risk of dementia and cardiovascular disease in women aged 65 years or older: a cohort study
Pregnancy hypertensive disease and risk of dementia and cardiovascular disease in women aged 65 years or older: a cohort study
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DOI：
10.1136/bmjopen-2015-009880
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发表时间：
2016-01-01
期刊：
影响因子：
2.9
通讯作者：
Wikstrom, A-K
中科院分区：
文献类型：
--
作者：
Nelander, M.;Cnattingius, S.;Wikstrom, A-K
目的：研究妊娠期高血压疾病与痴呆的关系。第二个目的是研究在老年人群中，妊娠高血压疾病后心血管疾病（CVD）和中风风险的增加是否持续存在。设计：队列研究。地点：瑞典。人群或样本：3232名65岁或以上的女性（平均71岁）。方法：考克斯比例风险回归分析用于计算暴露于妊娠期高血压疾病的女性的痴呆、CVD和/或中风的风险。从1998-2002年入选时的访谈中收集暴露数据。从入选当年至2010年底，从国家患者登记处和死亡原因登记处收集结局数据。年龄在纳入被设置为一个时间依赖性变量，并调整了身体质量指数，教育和吸烟。主要结果measures：痴呆症，心血管疾病，stroke.Results：在多年的后续行动中，7.6%的妇女暴露于妊娠高血压疾病收到了痴呆症的诊断，与7.4%之间未暴露的妇女（HR 1.19; 95%CI 0.79至1.73）。暴露妇女CVD的相应发生率为22.9%，未暴露妇女为19.0（HR 1.29; 95% CI 1.02 - 1.61），暴露女性和未暴露女性的卒中发生率分别为13.4%和10.7%（HR 1.36; 95%CI 1.00 - 1.81）。结论：在我们的队列中，自我报告的妊娠高血压疾病后痴呆的风险没有增加。我们发现，先前报道的妊娠高血压疾病后心血管疾病和中风风险增加在老年人群中持续存在。
Objective: The primary aim was to study pregnancy hypertensive disease and subsequent risk of dementia. The second aim was to study if the increased risks of cardiovascular disease (CVD) and stroke after pregnancy hypertensive disease persist in an elderly population.Design: Cohort study.Setting: Sweden.Population or sample: 3232 women 65 years or older (mean 71 years) at inclusion.Methods: Cox proportional hazards regression analyses were used to calculate risks of dementia, CVD and/or stroke for women exposed to pregnancy hypertensive disease. Exposure data were collected from an interview at inclusion during the years 1998-2002. Outcome data were collected from the National Patient Register and Cause of Death Register from the year of inclusion until the end of 2010. Age at inclusion was set as a time-dependent variable, and adjustments were made for body mass index, education and smoking.Main outcome measures: Dementia, CVD, stroke.Results: During the years of follow-up, 7.6% of the women exposed to pregnancy hypertensive disease received a diagnosis of dementia, compared with 7.4% among unexposed women (HR 1.19; 95% CI 0.79 to 1.73). The corresponding rates for CVD were 22.9% for exposed women and 19.0% for unexposed women (HR 1.29; 95% CI 1.02 to 1.61), and for stroke 13.4% for exposed women and 10.7% for unexposed women (HR 1.36; 95% CI 1.00 to 1.81).Conclusions: There was no increased risk of dementia after self-reported pregnancy hypertensive disease in our cohort. We found that the previously reported increased risk of CVD and stroke after pregnancy hypertensive disease persists in an older population.