在怀孕期间高血压的血压值和未来心血管风险
Andrea G Kattah1, Thais D Coutinho2, Jane Vermunt1
1Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
Mayo Clinic proceedings
|July 23, 2025
概括
降低妊娠高血压障碍 (HDP) 的血压值增加了HDP发生率,但没有改变HDP与未来心血管疾病 (CVD) 风险之间的关联.
科学领域:
- 心血管健康 心血管健康
- 产科和妇科 产科和妇科
- 流行病学 流行病学
背景情况:
- 妊娠高血压障碍 (HDP) 与长期心血管疾病 (CVD) 风险有关.
- 定义HDP的最佳血压值及其对心血管疾病协会的影响需要进一步调查.
研究的目的:
- 评估不同血压值 (≥140/90 vs. ≥130/80 mm Hg) 和心血管疾病风险因素如何影响妊娠高血压疾病 (HDP) 与未来心血管疾病之间的关联.
- 为了确定HDP诊断的较低血压值是否会影响观察到的与随后的心血管疾病事件的联系.
主要方法:
- 一组1755名年龄在45岁的孕妇被跟踪平均18.6年.
- 妊娠高血压的定义是使用两个值:≥140/90 mm Hg和≥130/80 mm Hg.
- 考克斯的比例危险模型被用于评估HDP-CVD关联,并根据各种CVD风险因素和人口统计学变量进行调整.
主要成果:
- 使用较低的值 (≥130/80 mm Hg) 确定了较高的HDP发病率 (44.4%),相比较高的值 (≥140/90 mm Hg) (15.0%).
- 无论使用何种值,终身和早产HDP都与未来心血管疾病风险增加有显著的关联.
- 只有在较低值 (≥130/80 mm Hg) 诊断出HDP的女性在45岁时患高血压的患病率较低.
结论:
- 虽然降低血压值会增加HDP的诊断率,但这并不会改变HDP与未来患心血管疾病的风险之间的基本关联.
- 这些发现强调了认识到HDP的重要性,即使在较低的血压升高时,也是未来心血管疾病风险的重要指标.
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