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Presión arterial elevada en el embarazo y posterior riesgo de enfermedad crónica
Tuija Männistö1, Pauline Mendola, Marja Vääräsmäki
1Division of Epidemiology, Statistics and Prevention Research, Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child, Health and Human Development, National Institutes of Health, Rockville, MD 20852, USA. mannistoTI@mail.nih.gov
Circulation
|February 13, 2013
Resumen
La hipertensión del embarazo, incluida la hipertensión gestacional, aumenta significativamente los riesgos a largo plazo de enfermedades cardiovasculares, enfermedades renales y diabetes mellitus. El monitoreo y la intervención temprana son cruciales para las mujeres afectadas.
Área de la Ciencia:
- Epidemiología cardiovascular y epidemiología cardiovascular.
- Salud reproductiva y salud reproductiva.
- Salud Pública La salud pública.
Sus antecedentes:
- La preeclampsia es un factor de riesgo conocido para futuras enfermedades cardiovasculares.
- Existen datos limitados sobre los riesgos cardiovasculares asociados con otras formas de hipertensión relacionada con el embarazo.
Objetivo del estudio:
- Para investigar los riesgos a largo plazo de enfermedades cardiovasculares, enfermedades renales y diabetes mellitus después de varios tipos de hipertensión durante el embarazo.
Principales métodos:
- Se utilizaron datos de la cohorte de nacimientos del norte de Finlandia de 1966 (N=10.314 mujeres).
- Recopila datos prospectivos sobre la presión arterial durante el embarazo a partir de registros prenatales y cuestionarios.
- Diagnósticos posteriores confirmados a través de registros finlandeses durante un seguimiento promedio de 39,4 años.
- Los ratios de riesgo ajustados empleados (HRs) para comparar los riesgos entre las mujeres hipertensas y normotensas.
Principales resultados:
- La hipertensión durante el embarazo, independientemente del tipo, se relacionó con riesgos elevados de enfermedades cardiovasculares posteriores y hipertensión arterial.
- La hipertensión gestacional aumentaba los riesgos de enfermedad cardíaca isquémica, infarto de miocardio, insuficiencia cardíaca, accidente cerebrovascular isquémico, enfermedad renal y diabetes mellitus.
- Se identificaron riesgos específicos para la hipertensión sistólica y diastólica aislada, incluida la muerte por infarto de miocardio y la enfermedad isquémica del corazón.
Conclusiones:
- La presión arterial elevada durante el embarazo es un fuerte indicador de alto riesgo futuro de enfermedad cardiovascular, enfermedad renal crónica y diabetes mellitus.
- Estos riesgos persisten incluso en ausencia de factores de riesgo conocidos.
- Se recomienda el monitoreo clínico, la evaluación de los factores de riesgo y las intervenciones oportunas para las mujeres con hipertensión relacionada con el embarazo.
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