在MADRES研究中,孕期血压轨迹和5年产后高血压风险在MADRES研究中
Zhongzheng Niu1, Elizabeth C Anderson2, Tingyu Yang1
1Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
JACC. Advances
|March 18, 2025
概括
在怀孕期间血压持续升高的孕妇面临更高的长期高血压风险. 这些高血压模式,即使是亚临床的,也可能会被标准的产前护理指南忽略.
科学领域:
- 产科和妇科 产科和妇科
- 心血管健康 心血管健康
- 生殖健康 生殖健康
背景情况:
- 怀孕涉及动态血压 (BP) 的变化.
- 了解妊娠期间异质血压模式对于评估长期高血压风险至关重要.
研究的目的:
- 为了识别不同的妊娠系统性血压 (SBP) 轨迹.
- 检查这些SBP轨迹与产后高血压风险之间的关联.
主要方法:
- 隐性类增长模型应用于MADRES队列中854名孕妇的SBP数据.
- 产后5年随访,以确定发生的高血压.
- 考克斯建模用于评估SBP轨迹组与产后高血压风险的关联.
主要成果:
- 确定了三个不同的妊娠SBP轨迹:"始终低" (80.2%),"始终高" (12.4%),和"高下降高" (7.4%).
- 与"始终高"和"高降高"组相比,与"始终低"组相比,产后高血压风险显著增加 (分别为4.91倍和5.44倍).
- "持续升高"组显示SBP温和升高,没有怀孕中期的下降,而"高下降-高"包括大多数孕前病例.
结论:
- 在怀孕期间持续升高的SBP,即使在亚临床范围内,也与长期高血压风险的增加有关.
- 标准的产前临床指导方针可能无法捕捉这些SBP模式升高的个体,突出显示了护理方面的潜在差距.
- 识别这些轨迹可以为预防产后高血压提供有针对性的干预措施.
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