Cardiac Abnormalities in Hispanic/Latina Women With Prior De Novo Hypertensive Disorders of Pregnancy.
Cardiac Abnormalities in Hispanic/Latina Women With Prior De Novo Hypertensive Disorders of Pregnancy.
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DOI：
10.1161/hypertensionaha.123.21248
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发表时间：
2024-02
期刊：
影响因子：
8.3
通讯作者：
Cheng, Susan
中科院分区：
文献类型：
--
作者：
Quesada, Odayme;Kulandavelu, Shathiyah;Vladutiu, Catherine J.;DeFranco, Emily;Minissian, Margo B.;Makarem, Nour;Bello, Natalie A.;Wong, Melissa S.;Pabon, Maria A.;Chandra, Alvin A.;Aviles-Santa, Larissa;Rodriguez, Carlos J.;Bairey Merz, C. Noel;Sofer, Tamar;Hurwitz, Barry E.;Talavera, Gregory A.;Claggett, Brian L.;Solomon, Scott D.;Cheng, Susan
关键词：
妊娠期高血压疾病 (HDP) 与孕产妇患心血管疾病的长期风险相关，其原因尚不完全清楚。 HCHS/SOL（西班牙裔社区健康研究/拉丁裔研究）是一个多中心社区队列，招募了 2008 年至 2011 年的西班牙裔/拉丁裔成年人，用于评估既往妊娠次数≥1 次的西班牙裔/拉丁裔女性的新发 HDP（妊娠高血压、先兆子痫、子痫）病史与心脏结构和功能超声心动图测量值之间的关联，以及关联介导的比例目前的高血压（>140/90 mm Hg 或抗高血压治疗）。该研究队列包括 5168 名西班牙裔/拉丁裔女性，超声心动图检查时的平均年龄 (SD) 为 58.7 (9.7) 岁。 724 名 (14%) 的研究女性报告既往患有 HDP，且与左心室 (LV) 射血分数较低 -0.66（95% 置信区间 [CI]，-1.21 至 -0.11）、较高的 LV 相对壁厚度 0.09（95% CI，0–0.18）和 1.39（95% CI，1.02–1.89）的较高风险相关。调整血压和其他混杂因素后左室几何形状异常。当前高血压介导的 HDP 与左室射血分数之间的关联比例为 0.09（95% CI，0.03-0.45），左室相对壁厚为 0.28（95% CI，0.16-0.51），左室几何形状异常为 0.14（95% CI，0.12-0.48），向心性左心室肥厚为 0.31 (95% CI, 0.19–0.86)，异常左室舒张功能障碍为 0.58 (95% CI, 0.26–0.79)。在一大群西班牙裔/拉丁裔女性中，有新发 HDP 病史的女性在心脏结构以及收缩和舒张功能障碍方面存在可检测和可测量的亚临床改变，而这些改变仅部分由当前高血压介导。
Hypertensive disorders of pregnancy (HDP) are associated with long-term maternal risks for cardiovascular disease for reasons that remain incompletely understood. The HCHS/SOL (Hispanic Community Health Study/Study of Latinos), a multi-center community-based cohort of Hispanic/Latino adults recruited 2008 to 2011, was used to evaluate the associations of history of de novo HDP (gestational hypertension, preeclampsia, eclampsia) with echocardiographic measures of cardiac structure and function in Hispanic/Latina women with ≥1 prior pregnancy and the proportion of association mediated by current hypertension (>140/90 mm Hg or antihypertensive therapy). The study cohort included 5168 Hispanic/Latina women with an average age (SD) of 58.7 (9.7) years at time of echocardiogram. Prior de novo HDP was reported by 724 (14%) of the women studied and was associated with lower left ventricle (LV) ejection fraction −0.66 (95% confidence interval [CI], −1.21 to −0.11), higher LV relative wall thickness 0.09 (95% CI, 0–0.18), and 1.39 (95% CI, 1.02–1.89) higher risk of abnormal LV geometry after adjusting for blood pressure and other confounders. The proportion of the association mediated by current hypertension between HDP and LV ejection fraction was 0.09 (95% CI, 0.03–0.45), LV relative wall thickness was 0.28 (95% CI, 0.16–0.51), abnormal LV geometry was 0.14 (95% CI, 0.12–0.48), concentric left ventricular hypertrophy was 0.31 (95% CI, 0.19–0.86), and abnormal LV diastolic dysfunction was 0.58 (95% CI, 0.26–0.79). In a large cohort of Hispanic/Latina women those with history of de novo HDP had detectable and measurable subclinical alterations in cardiac structure and both systolic and diastolic dysfunction that were only partially mediated by current hypertension.