Prospective Evaluation of Cardiovascular Risk 10 Years After a Hypertensive Disorder of Pregnancy.
Prospective Evaluation of Cardiovascular Risk 10 Years After a Hypertensive Disorder of Pregnancy.
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DOI：
10.1016/j.jacc.2022.03.383
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发表时间：
2022-06-21
影响因子：
24
通讯作者：
Lewey, Jennifer
中科院分区：
文献类型：
--
作者：
Levine, Lisa D.;Ky, Bonnie;Chirinos, Julio A.;Koshinksi, Jessica;Arany, Zoltan;Riis, Valerie;Elovitz, Michal A.;Koelper, Nathanael;Lewey, Jennifer
妊娠期高血压疾病(HDP)与20-30年后心血管疾病(CVD)风险的增加有关；然而，HDP后10年的心血管风险(CV)研究较少。这项研究的目的是评估10年前有和没有HDP病史的一组具有良好特征的种族多样性患者在心血管危险因素和亚临床CVD方面的差异。这是一项前瞻性研究，研究对象为10年前(2005年至2007年)诊断为≥的患者和未诊断为HDP的患者，他们接受了超声心动图、动脉血压测量和血流介导的肱动脉扩张术。共有135名患者完成了评估(84名有HDP病史，51名没有HDP病史)；85%的患者自认为是黑人。有HDP病史的患者新发高血压的风险是无HDP患者的2.4倍(56.0%比23.5%；调整后的相对风险：2.4；95%CI：1.39-4.14)，在左心室结构、整体纵向应变、舒张期功能、动脉僵硬或内皮功能方面没有差异。无论有无高血压病史，高血压患者较无高血压患者有更大的左室重构，包括较大的相对室壁厚度；较差的舒张期功能，包括较低的间隔和侧壁e‘及E/A比值；较多的异常纵向应变；以及较高的有效动脉弹性。我们发现HDP后10年患高血压的风险增加了2.4倍。心血管风险的非侵入性测量的差异主要是由高血压的诊断推动的，与HDP病史无关，这表明已知的HDP后心血管疾病的长期风险可能主要是高血压发展的结果。
Hypertensive disorders of pregnancy (HDP) are associated with increased risk of cardiovascular disease (CVD) 20–30 years later; however, cardiovascular (CV) risk in the decade after HDP is less studied. The purpose of this study was to evaluate differences in CV risk factors as well as subclinical CVD among a well-characterized group of racially diverse patients with and without a history of HDP 10 years earlier. This is a prospective study of patients with and without a diagnosis of HDP ≥10 years earlier (2005–2007) who underwent in-person visits with echocardiography, arterial tonometry, and flow-mediated dilation of the brachial artery. A total of 135 patients completed assessments (84 with and 51 without a history of HDP); 85% self-identified as Black. Patients with a history of HDP had a 2.4-fold increased risk of new hypertension compared with those without HDP (56.0% vs. 23.5%; adjusted relative risk: 2.4; 95% CI: 1.39–4.14) with no differences in measures of left ventricular structure, global longitudinal strain, diastolic function, arterial stiffness, or endothelial function. Patients who developed hypertension, regardless of HDP history, had greater left ventricular remodeling, including greater relative wall thickness; worse diastolic function, including lower septal and lateral e’ and E/A ratio; more abnormal longitudinal strain; and higher effective arterial elastance than patients without hypertension. We found a 2.4-fold increased risk of hypertension 10 years after HDP. Differences in noninvasive measures of CV risk were driven mostly by the hypertension diagnosis, regardless of HDP history, suggesting that the known long-term risk of CVD after HDP may primarily be a consequence of hypertension development.
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影响因子：
18.2
作者：
Chirinos JA;Londono-Hoyos F;Zamani P;Beraun M;Haines P;Vasim I;Varakantam S;Phan TS;Cappola TP;Margulies KB;Townsend RR;Segers P
通讯作者：
Segers P
DOI：
10.1136/bmj.j3078
发表时间：
2017-07-12
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Behrens I;Basit S;Melbye M;Lykke JA;Wohlfahrt J;Bundgaard H;Thilaganathan B;Boyd HA
通讯作者：
Boyd HA
DOI：
10.1016/j.jash.2016.01.012
发表时间：
2016-04-01
影响因子：
--
作者：
Al-Nashi, Maha;Eriksson, Maria J.;Kahan, Thomas
通讯作者：
Kahan, Thomas
影响因子：
24
作者：
Greenland, Philip;Alpert, Joseph S.;Whitman, Gayle R.
通讯作者：
Whitman, Gayle R.
影响因子：
24
作者：
Grundy, Scott M.;Stone, Neil J.;Wijeysundera, Duminda N.
通讯作者：
Wijeysundera, Duminda N.