怀孕期间的高血压和以后的心血管风险:常见的先例?
Pål R Romundstad1, Elisabeth B Magnussen, George Davey Smith
1Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway. paalr@ntnu.no
Circulation
|July 28, 2010
概括
孕前和孕期高血压与未来的心血管疾病有关. 然而,共同的妊娠前风险因素,而不是妊娠状况本身,在很大程度上解释了这种关联.
科学领域:
- 心血管流行病学心血管流行病学
- 生殖健康 生殖健康
- 公共卫生 公共卫生
背景情况:
- 孕前和孕期高血压会增加长期心血管疾病 (CVD) 的风险.
- 这种关联的根本原因需要进一步调查.
研究的目的:
- 为了确定怀孕引起的高血压是否有助于后来的心血管疾病风险.
- 为了区分怀孕期间因素与怀孕前共同的风险因素的作用.
主要方法:
- 利用了来自北德拉格健康研究 (HUNT) 和挪威医疗出生登记处的纵向数据.
- 包括3225名单独分娩的妇女,分析妊娠前和妊娠后血压,BMI和血清脂质的测量.
主要成果:
- 孕前/孕期高血压的妇女在怀孕前的BMI,血压和不利的脂质状况都较高.
- 根据怀孕前的因素进行调整,可观测到的BMI (>65%) 和血压 (约50%) 的差异显著减弱.
- 在调整后,脂质差异 (HDL胆固醇和甘油三) 也大幅减少 (分别为40%和72%).
结论:
- 妊娠高血压疾病与怀孕后心血管疾病风险因素之间的关联在很大程度上归因于怀孕前的共同风险因素.
- 怀孕期间的高血压疾病可能不会直接导致长期的心血管风险.
- 专注于怀孕前的风险因素管理对于减轻受影响妇女未来心脏病的风险至关重要.
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