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Prevention and Screening for Cardiometabolic Disease Following Hypertensive Disorders in Pregnancy in Low-Resource

Salisu Mohammed Ishaku1, Kwame Adu-Bonsaffoh2,3, Natasha Housseine2,4

  • 1Julius Global Health, Julius Center for Health Science and Primary Care, University Medical Center, Utrecht, NL.

Global Heart
|May 1, 2023
PubMed

Insights

Hypertensive disorders in pregnancy (HDP) increase the risk of cardiometabolic and kidney diseases. This study developed 33 practical, scalable recommendations for screening and prevention in low- and middle-income countries (LMICs).

Area of Science:

  • Public Health
  • Cardiology
  • Nephrology

Background:

  • Hypertensive disorders in pregnancy (HDP) are increasing in low- and middle-income countries (LMICs) and are known risk factors for future cardiometabolic and kidney diseases.
  • Effective, scalable, and cost-effective strategies for screening and prevention in women with a history of HDP are lacking in LMIC settings.
  • Existing international guidelines require adaptation to suit the specific contexts and resource limitations of LMICs.

Approach:

  • A systematic review of guidelines and recommendations for the prevention and screening of cardiometabolic and chronic kidney diseases post-HDP was conducted.
  • Literature searches were performed in PubMed/Medline, Embase, and Cochrane Library for articles and guidelines published between 2010 and 2021.
  • Findings were synthesized, and a summary of recommendations underwent two rounds of Delphi consensus surveys with experts experienced in LMIC settings.

Key Points:

  • Thirty-five clinical recommendations were synthesized across six domains: identification of women with HDP, counseling and health education timing, care structure and setting, information needs, and cardiometabolic and biomarker thresholds.
  • The Delphi panel achieved consensus on 33 final recommendations.
  • These recommendations offer practical and scalable approaches for health workers in LMICs.

Conclusions:

  • The developed recommendations provide a framework for effective screening and prevention of cardiometabolic diseases following HDP in LMICs.
  • Implementation and evaluation of these recommendations can help mitigate the growing burden of noncommunicable diseases in these regions.
  • Tailored strategies are crucial for managing long-term health risks associated with HDP in resource-limited settings.

Keywords:
Hypertensive disorders in pregnancyprevention and screening strategiesrisks of future cardiometabolic diseases

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