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2017 ; 24
(16
): 1735-1745
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Preventing cardiovascular disease after hypertensive disorders of pregnancy:
Searching for the how and when
#MMPMID28895439
Groenhof TKJ
; van Rijn BB
; Franx A
; Roeters van Lennep JE
; Bots ML
; Lely AT
Eur J Prev Cardiol
2017[Nov]; 24
(16
): 1735-1745
PMID28895439
show ga
Background Women with a history of a hypertensive disorder during pregnancy (HDP)
have an increased risk of cardiovascular events. Guidelines recommend assessment
of cardiovascular risk factors in these women later in life, but provide limited
advice on how this follow-up should be organized. Design Systematic review and
meta-regression analysis. Methods The aim of our study was to provide an overview
of existing knowledge on the changes over time in three major modifiable
components of cardiovascular risk assessment after HDP: blood pressure, glucose
homeostasis and lipid levels. Data from 44 studies and up to 6904 women with a
history of a HDP were compared with risk factor levels reported for women of
corresponding age in the National Health And Nutrition Examination Survey,
Estudio Epidemiólogico de la Insuficiencia Renal en España and Hong Kong cohorts
( N?=?27,803). Results Compared with the reference cohort, women with a HDP
presented with higher mean blood pressure. Hypertension was present in a higher
rate among women with a previous HDP from 15 years postpartum onwards. At 15
years postpartum (±age 45), one in five women with a history of a HDP suffer from
hypertension. No differences in glucose homeostasis parameters or lipid levels
were observed. Conclusions Based on our analysis, it is not possible to point out
a time point to commence screening for cardiovascular risk factors in women after
a HDP. We recommend redirection of future research towards the development of a
stepwise approach identifying the women with the highest cardiovascular risk.
|*Cardiovascular Diseases/epidemiology/etiology/prevention & control
[MESH]