Hypertensive disorders first identified in pregnancy increase risk for incident prehypertension and hypertension in the year after delivery

被引:51
作者
Black, Mary Helen [1 ]
Zhou, Hui [1 ]
Sacks, David A. [1 ]
Dublin, Sascha [2 ]
Lawrence, Jean M. [1 ]
Harrison, Teresa N. [1 ]
Reynolds, Kristi [1 ]
机构
[1] Kaiser Permanente So Calif, Dept Res & Evaluat, 100 S Los Robles,2nd Floor, Pasadena, CA 91101 USA
[2] Grp Hlth Res Inst, Seattle, WA USA
关键词
cardiovascular disease; hypertension; hypertensive disorders of pregnancy; preeclampsia; prehypertension; GESTATIONAL DIABETES-MELLITUS; CARDIOVASCULAR-DISEASE; BLOOD-PRESSURE; WEIGHT-GAIN; PREECLAMPSIA; HISTORY; WOMEN; MORTALITY; DIAGNOSIS; MOTHERS;
D O I
10.1097/HJH.0000000000000855
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Background:Hypertensive disorders in pregnancy, including preeclampsia/eclampsia (PE/E) are associated with long-term cardiovascular disease risk. However, little is known about the effect of these conditions on risk for prehypertension (preHTN) or hypertension (HTN) in the early years after delivery.Methods:The cohort consisted of women who had prenatal care and delivered a live singleton neonate at Kaiser Permanente Bellflower Medical Center in 2005-2010. Women with prepregnancy HTN or preHTN were excluded from analysis. Multivariable robust Poisson regression models were used to assess associations between any hypertensive disorder or PE/E and development of preHTN/HTN in the year after delivery, adjusted for maternal age, race/ethnicity, parity, smoking, prepregnancy weight status, gestational weight gain, gestational diabetes, and gestational age.Results:Among 5960 women who were normotensive prior to pregnancy, 358 (6.0%) developed a hypertensive disorder in pregnancy, of whom 215 (60.1%) had PE/E. Overall, 63 (1.1%) developed HTN and 902 (15.1%) preHTN in the year after delivery. After accounting for all potential confounders, women with a hypertensive disorder in pregnancy and those with PE/E were 2.36 (95% confidence interval: 1.97-2.83) and 2.48 (95% confidence interval: 1.99-3.11) times as likely, respectively, to develop preHTN/HTN in the year after delivery as those without pregnancy-related HTN. Results were similar with and without adjustment for gestational diabetes.Conclusion:Our findings highlight the need for prospective studies aimed at determining whether early postpartum screening and improved follow-up of women with hypertensive disorders first identified in pregnancy may prevent future cardiovascular disease.
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页码:728 / 735
页数:8
相关论文
共 31 条
[1]   Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis [J].
Bellamy, Leanne ;
Casas, Juan-Pablo ;
Hingorani, Aroon D. ;
Williams, David J. .
BMJ-BRITISH MEDICAL JOURNAL, 2007, 335 (7627) :974-977
[2]   Prehypertension prior to or during early pregnancy is associated with increased risk for hypertensive disorders in pregnancy and gestational diabetes [J].
Black, Mary Helen ;
Zhou, Hui ;
Sacks, David A. ;
Dublin, Sascha ;
Lawrence, Jean M. ;
Harrison, Teresa N. ;
Reynolds, Kristi .
JOURNAL OF HYPERTENSION, 2015, 33 (09) :1860-1867
[3]   The Relative Contribution of Prepregnancy Overweight and Obesity, Gestational Weight Gain, and IADPSG-Defined Gestational Diabetes Mellitus to Fetal Overgrowth [J].
Black, Mary Helen ;
Sacks, David A. ;
Xiang, Anny H. ;
Lawrence, Jean M. .
DIABETES CARE, 2013, 36 (01) :56-62
[4]   Clinical Outcomes of Pregnancies Complicated by Mild Gestational Diabetes Mellitus Differ by Combinations of Abnormal Oral Glucose Tolerance Test Values [J].
Black, Mary Helen ;
Sacks, David A. ;
Xiang, Anny H. ;
Lawrence, Jean M. .
DIABETES CARE, 2010, 33 (12) :2524-2530
[5]   Maternal central hemodynamics in hypertensive disorders of pregnancy [J].
Bosio, PM ;
McKenna, PJ ;
Conroy, R ;
O'Herlihy, C .
OBSTETRICS AND GYNECOLOGY, 1999, 94 (06) :978-984
[6]  
Chapman Julia A, 2013, Nurs Manage, V44, P22, DOI 10.1097/01.NUMA.0000433385.87884.5c
[7]  
CHOBANIAN AV, 2003, JAMA-J AM MED ASSOC, V289, P2560, DOI DOI 10.1161/01.HYP.0000107251.49515.C2
[8]   Hypertension in pregnancy as a risk factor for cardiovascular disease later in life [J].
Garovic, Vesna D. ;
Bailey, Kent R. ;
Boerwinkle, Eric ;
Hunt, Steven C. ;
Weder, Alan B. ;
Curb, David ;
Mosley, Thomas H., Jr. ;
Wiste, Heather J. ;
Turner, Stephen T. .
JOURNAL OF HYPERTENSION, 2010, 28 (04) :826-833
[9]   Thrombosis in pregnancy: maternal and fetal issues [J].
Greer, IA .
LANCET, 1999, 353 (9160) :1258-1265
[10]   Cardiovascular risk estimation in women with a history of hypertensive pregnancy disorders at term: a longitudinal follow-up study [J].
Hermes, Wietske ;
Tamsma, Jouke T. ;
Grootendorst, Diana C. ;
Franx, Arie ;
van der Post, Joris ;
van Pampus, Maria G. ;
Bloemenkamp, Kitty W. M. ;
Porath, Martina ;
Mol, Ben W. ;
de Groot, Christianne J. M. .
BMC PREGNANCY AND CHILDBIRTH, 2013, 13