Risk of Adult Hypertension in Offspring From Pregnancies Complicated by Hypertension: Population-Based Estimates.
Risk of Adult Hypertension in Offspring From Pregnancies Complicated by Hypertension: Population-Based Estimates.
复制标题
妊娠并发高血压的后代患成人高血压的风险：基于人群的估计。
DOI：
10.1161/hypertensionaha.123.20282
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Garovic,VesnaD
中科院分区：
文献类型：
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作者：
Dines,VirginiaA;Kattah,AndreaG;Weaver,AmyL;Vaughan,LisaE;Chamberlain,AlannaM;Bielinski,SuzetteJ;Mielke,MichelleM;Garovic,VesnaD
背景妊娠期高血压疾病（HDP）与母亲和后代慢性高血压的风险增加有关。我们试图在一项基于人群的大型队列研究中量化受 HDP 影响的妊娠后代慢性高血压的发病率。此外，我们还评估了子代子宫内 HDP 暴露与母体慢性高血压之间的关联。方法我们对 1976 年至 1982 年出生的 8755 名个体进行了一项基于人群的队列研究，其中包括 7544 名妇女，她们在分娩时都居住在同一社区。 HDP 是使用之前经过验证的算法来识别的。使用诊断代码确定母亲及其后代的慢性高血压的诊断。 Cox比例风险回归用于评估HDP与慢性高血压之间的关联。结果HDP暴露（风险比，1.50 [95% CI，1.18–1.90]）和母亲慢性高血压（风险比，1.73 [95% CI，1.48–2.02]）均与后代慢性高血压风险显着增加相关。当将这两个危险因素一起纳入多变量模型时，这两个危险因素仍然与后代高血压风险增加显着相关。两种暴露均与后代高血压风险增加 2.4 倍相关，表明存在协同累加相互作用。 结论 妊娠期 SHDP 暴露和母亲高血压均与后代慢性高血压风险增加独立相关。我们的结果表明，除了母亲慢性高血压之外，子宫内 HDP 暴露可能会导致后代患高血压的风险更大。
BACKGROUNDHypertensive disorders of pregnancy (HDP) have been associated with an increased risk of chronic hypertension for both mothers and offspring. We sought to quantify the incidence of chronic hypertension in offspring from HDP-affected pregnancies in a large, population-based cohort study. Furthermore, we evaluate the association of HDP exposure in utero and maternal chronic hypertension in offspring.METHODSWe performed a population-based cohort study of 8755 individuals born during 1976 to 1982 to 7544 women who all resided in the same community at the time of delivery. HDP were identified using a previously validated algorithm. Diagnosis of chronic hypertension in mothers and their offspring was determined using diagnostic codes. Cox proportional hazards regression was used to assess the association between HDP and chronic hypertension.RESULTSHDP exposure (hazard ratio, 1.50 [95% CI, 1.18–1.90]) and maternal chronic hypertension (hazard ratio, 1.73 [95% CI, 1.48–2.02]) were both associated with a significant increased risk for chronic hypertension in offspring. Both risk factors remained significantly associated with increased risk of hypertension in offspring when included together in a multivariate model. Having both exposures was associated with a 2.4-fold increase in the risk of hypertension in offspring, suggesting a synergistic additive interaction.CONCLUSIONSHDP exposure in gestation and maternal hypertension are both independently associated with an increased risk of chronic hypertension in offspring. Our results suggest that HDP exposure in utero, in addition to maternal chronic hypertension, may lead to a greater risk for the development of hypertension in offspring.