Related Experiment Video
Updated: Jan 30, 2026
Design and Implementation of an fMRI Study Examining Thought Suppression in Young Women with, and At-risk, for Depression
Published on: May 19, 2015
Cardiovascular Risk Assessment and Follow-Up of Women After Hypertensive Disorders of Pregnancy:A Prospective Cohort
Rachel A Gladstone1, Jessica Pudwell1, Kara A Nerenberg2
1Department of Obstetrics and Gynaecology, Kingston Heath Sciences Centre, Queen's University, Kingston, ON.
Insights
Hypertensive disorders of pregnancy (HPP) significantly underestimate cardiovascular disease (CVD) risk in women. Early prevention strategies are crucial for improving long-term CVD outcomes in this population.
Area of Science:
- Cardiovascular Medicine
- Obstetrics & Gynecology
- Public Health
Background:
- Hypertensive disorders of pregnancy (HDP) are an independent risk factor for future cardiovascular disease (CVD) in women.
- Current cardiovascular risk assessment models may not adequately identify women with HDP who require further screening or treatment.
Purpose of the Study:
- To evaluate the effectiveness of the 2016 Canadian Cardiovascular Society (CCS) lipid guidelines in assessing CVD risk in women post-HDP.
- To compare CVD risk stratification using CCS guidelines and a cardiometabolic life expectancy model in women with and without HDP history.
Main Methods:
- Utilized data from the postpartum Maternal Health Clinic and the Preeclampsia New Emerging Team (PE-NET) cohort.
- Applied 10-year, 30-year, and lifetime CVD risk scores from CCS guidelines and a cardiometabolic model.
- Canadian Task Force Classification II-2.
Main Results:
- The 10-year CCS risk score underestimated CVD risk, classifying all women as low risk.
- 30-year and lifetime risk scores revealed significant CVD risk reclassification in women with HDP (49.2% high risk vs. 14.3% controls).
- The cardiometabolic model showed significantly lower life expectancy and earlier predicted CVD onset in the HDP group.
Conclusions:
- The 2016 CCS lipid guidelines significantly underestimate lifelong CVD risk in women with a history of HDP.
- Women with HDP experience reduced cardiometabolic life expectancy and earlier predicted CVD onset.
- Implementing early primary prevention strategies for women post-HDP is essential to improve CVD outcomes and reduce healthcare burden.
Objective:
Hypertensive disorders of pregnancy (HDP) comprise an independent, sex-specific risk factor for cardiovascular disease (CVD) in women. This study examined the utility of CVD risk models proposed in the 2016 Canadian Cardiovascular Society (CCS) lipid guidelines to identify women requiring further screening or lipid treatment following HDP.
Methods:
Using data collected from the postpartum Maternal Health Clinic (MHC) at Kingston General Hospital in Kingston, Ontario and the Preeclampsia New Emerging Team (PE-NET) cohort study, the study investigators used the models recommended by the CCS guidelines and the cardiometabolic model of life expectancy in each cohort to estimate CVD risk in women after HDP. (Canadian Task Force Classification II-2).
Results:
Using the 10-Year Modified Framingham Risk Score, all women were classified by the 2016 CCS Guidelines as low risk, requiring no follow-up. The 30-Year and Lifetime Risk Scores resulted in significant reclassification of women at risk in the PE-NET control and HDP groups (P < 0.001 and P < 0.0001, respectively); 49.2% of women with HDP were classified as high risk, requiring follow-up, compared with 14.3% of control subjects. Using the cardiometabolic model, median life expectancy was significantly lower and expected onset of CVD was earlier in the HDP group compared with the control group (P < 0.0001).
Conclusion:
The 2016 CCS lipid guidelines' risk classification recommendations significantly underestimated lifelong CVD risk in the HDP group compared with the control group. Women with HDP also had a significant decrease in cardiometabolic life expectancy and an earlier predicted age at onset of CVD. Early primary prevention in this at-risk population may improve CVD outcomes and reduce the future burden on the health care system.
More Related Videos
10:11Fundus Photography as a Convenient Tool to Study Microvascular Responses to Cardiovascular Disease Risk Factors in Epidemiological Studies
Published on: October 22, 2014
19:15Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Related Concept Videos
01:29Assessment of the Cardiovascular System II: Inspection
Head and Neck
01:25Assessment of the Cardiovascular System IV: Auscultation
Normal Heart Sounds
S1 (First Heart Sound)-
S1 is made by the closure of the mitral and tricuspid valves (atrioventricular valves), marking the beginning of systole.
S2 (Second Heart Sound)-
S2 is made by the closure of the aortic and pulmonic valves (semilunar valves), marking the end of the systole.
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:27Assessment of the Cardiovascular System III: Palpation
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
01:28Imaging Studies for Cardiovascular System V: CT