Cardio-Obstetrics: the Next Frontier in Cardiovascular Disease Prevention.
Cardio-Obstetrics: the Next Frontier in Cardiovascular Disease Prevention.
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DOI：
10.1007/s11883-022-01026-6
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发表时间：
2022-07
影响因子：
5.8
通讯作者：
Sharma, Garima
中科院分区：
文献类型：
--
作者：
Thakkar, Aarti;Hailu, Tigist;Blumenthal, Roger S.;Martin, Seth S.;Harrington, Colleen M.;Yeh, Doreen DeFaria;French, Katharine A.;Sharma, Garima
在国际上，心血管疾病（CVD）是女性死亡的主要原因。随着心血管疾病风险因素的持续上升，早期识别和管理慢性疾病，如高血压，糖尿病和阻塞性睡眠呼吸暂停是预防的必要条件。对于有危险因素且可能容易患心血管疾病的女性来说，怀孕是一种自然的压力测试，它不仅提供了识别疾病并实施有效且持久的预防策略的独特机会。预防从怀孕前开始，因为孕前筛查，咨询和慢性病的优化可以改善孕产妇和胎儿的结局。在整个怀孕期间，妇女应保持密切的随访，继续重新评估危险因素，必要时进行咨询。在分娩后3个月的“第四个三个月”期间继续进行医疗保健，使临床医生能够继续监测慢性疾病的演变，鼓励持续的生活方式咨询，并在必要时将妇女与初级保健和适当的专家联系起来。不幸的是，这一产后时期是一个重大的护理差距，因为大部分妇女不参加其预定的访问。健康的社会决定因素，包括获得护理的机会减少和经济不稳定，导致整个怀孕期间的风险因素增加，但特别是在产后随访依从性差方面发挥作用。使用远程医疗诊所和远程监测可能证明是有效的干预措施，弥合了医生和患者之间的差距，并改善了对高危妇女的后续行动。虽然许多临床医生开始了解心血管疾病对女性的影响，但筛查和预防策略往往要到晚年才能实施。怀孕创造了一个机会，使妇女开始参与心血管保护战略之前，疾病的发展。
Internationally, cardiovascular disease (CVD) is the leading cause of death in women. With risk factors for CVD continuing to rise, early identification and management of chronic diseases such as hypertension, diabetes, and obstructive sleep apnea is necessary for prevention. Pregnancy is a natural stress test for women with risk factors who may be predisposed to CVD and offers a unique opportunity to not only recognize disease but also implement effective and long-lasting strategies for prevention. Prevention begins before pregnancy, as preconception screening, counseling, and optimization of chronic diseases can improve maternal and fetal outcomes. Throughout pregnancy, women should maintain close follow-up, continued reevaluation of risk factors, with counseling when necessary. Continued healthcare engagement during the “fourth trimester,” 3 months following delivery, allows clinicians to continue monitoring the evolution of chronic diseases, encourage ongoing lifestyle counseling, and connect women with primary care and appropriate specialists if needed. Unfortunately, this postpartum period represents a major care gap, as a significant proportion of most women do not attend their scheduled visits. Social determinants of health including decreased access to care and economic instability lead to increased risk factors throughout pregnancy but particularly play a role in poor compliance with postpartum follow-up. The use of telemedicine clinics and remote monitoring may prove to be effective interventions, bridging the gap between physicians and patients and improving follow-up for at-risk women. While many clinicians are beginning to understand the impact of CVD on women, screening and prevention strategies are not often implemented until much later in life. Pregnancy creates an opportunity to begin engaging women in cardiovascular protective strategies before the development of the disease.
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影响因子：
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作者：
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通讯作者：
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影响因子：
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