Cardiovascular disease risk is only elevated in hypertensive, formerly preeclamptic women
Cardiovascular disease risk is only elevated in hypertensive, formerly preeclamptic women
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DOI：
10.1111/1471-0528.13057
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发表时间：
2015-07-01
影响因子：
5.8
通讯作者：
Spaanderman, M. E. A.
中科院分区：
文献类型：
--
作者：
Breetveld, N. M.;Ghossein-Doha, C.;Spaanderman, M. E. A.
目的分析预测10年和30年的心血管疾病（CVD）的风险评分的患者谁经历了先兆子痫（PE）5-10年前与健康的parous controls.Design观察性研究设置三级转诊医院在荷兰人口115例PE和50对照组的历史。PE患者分为两组，高血压（n = 21）和血压正常（n = 94），根据使用抗高血压药物，并根据PE的发病分为亚组：早发性PE（n = 39）和晚发性PE（n = 76）。我们测量了体重、身高和血压。分析空腹血糖、胰岛素和血脂水平。所有参与者都完成了一份经过验证的问卷。计算并比较10年和30年Frachial风险评分。主要结果测量估计Frachial 10年和30年CVD风险评分。结果总体10年和30年CVD中位风险加权受试者的血脂在以前的PE妇女和对照组之间是可比的;分别为1.6与1.5%（P = 0.22）和9.0与9.0%（P = 0.49）。然而，高血压前PE女性的CVD风险是血压正常前PE女性的两倍：10年和30年CVD中位风险分别为3.1%和1.5%（P < 0.01）和19.0%和8.0%（P < 0.01）。基于BMI而不是血脂的风险估计显示出相当的结果。早发性PE更常聚集在高血压既往PE组中，与晚发性PE组相比，基于血脂的10年和30年CVD风险估计值显著更高：1.7%对1.3%（P < 0.05）和10.0对比7.0%结论子痫前期后高血压妇女在未来10-30年内发生CVD的危险性增加2倍。在先兆子痫妊娠后的前10年内血压正常的既往PE妇女与健康对照者具有可比的未来心血管风险。
Objective To analyse the predicted 10- and 30-year risk scores for cardiovascular disease (CVD) in patients who experienced preeclampsia (PE) 5-10 years previously compared with healthy parous controls.Design Observational study.Setting Tertiary referral hospital in the Netherlands.Population One hundred and fifteen patients with a history of PE and 50 controls. PE patients were categorised into two groups, hypertensive (n = 21) and normotensive (n = 94), based on use of antihypertensive medication, and next categorised into subgroups based on the onset of PE: early-onset PE (n = 39) and late-onset PE (n = 76).Methods All participants underwent cardiovascular risk screening 5-10 years after index pregnancy. We measured body mass, height and blood pressure. Blood was analysed for fasting glucose, insulin and lipid levels. All participants completed a validated questionnaire. The 10- and 30-year Framingham risk scores were calculated and compared.Main outcome measures Estimated Framingham 10- and 30-year risk scores for CVD.Results The overall 10- and 30-year CVD median risks weighing subjects' lipids were comparable between formerly PE women and controls; 1.6 versus 1.5% (P = 0.22) and 9.0 versus 9.0% (P = 0.49), respectively. However, hypertensive formerly PE women have twice the CVD risk as normotensive formerly PE women: 10- and 30-year CVD median risks were 3.1 versus 1.5% (P < 0.01) and 19.0% versus 8.0% (P < 0.01), respectively. Risk estimates based on BMI rather than lipid profile show comparable results. Early-onset PE clustered more often in the hypertensive formerly PE group and showed significantly higher 10-and 30-year CVD risk estimates based on lipids compared with the late-onset PE group: 1.7 versus 1.3% (P < 0.05) and 10.0 versus 7.0% (P < 0.05), respectively.Conclusions Women who are hypertensive after preeclampsia, have a twofold risk of developing CVD in the next 10-30 years. Formerly PE women who are normotensive in the first 10 years after their preeclamptic pregnancy have a comparable future cardiovascular risk to healthy controls.