LACTATION AND MATERNAL SUBCLINICAL CARDIOVASCULAR DISEASE AMONG WOMEN WITH AND WITHOUT A HISTORY OF HYPERTENSIVE DISORDERS OF PREGNANCY

2018 ◽  
Vol 71 (11) ◽  
pp. A1787
Author(s):  
Malamo Countouris ◽  
Claudia Holzman ◽  
Gabrielle Snyder ◽  
Andrew Althouse ◽  
Steven Reis ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
History Of ◽  
Subclinical Cardiovascular Disease

scholarly journals Association between hypertensive disorders of pregnancy and cardiovascular disease in a population of Cameroonian women at two hospitals of yaounde : a case control study

2018 ◽  
Author(s):  
Benedict Taa Nguimbis Esseme ◽  
Mbondji Ebongué
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Gestational Hypertension ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Pediatric Care ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
History Of

AbstractBackground: Positive associations have been found between Hypertensive Disorders of Pregnancy gestational hypertension, preeclampsia and cardiovascular diseases within non-black African populations, but no data exist from sub-Saharan Africa. We aimed to assess this association in Cameroonian mothers.Methods: We used a case-control design. Cases were women diagnosed with arteriosclerotic cardiovascular disease between 2012 and 2017 at the General and the Gyneco-obstetric hospital of Yaoundé. Controls were mothers of children who seeked pediatric care at the Gyneco-obstetric hospital of Yaoundé, with no diagnosis of cardiovascular disease. We abstracted data from patient files to assess cardiovascular disease, and used phone-based questionnaires to assess prior history of Hypertensive Disorders of Pregnancy. We used logistic regression and propensity scores for adjustment. Results: Out of 1228 individuals selected, 173 cases and 339 controls participated in the study. We found no increased risk of cardiovascular diseases for women with a history of Hypertensive Disorders of Pregnancy (OR = 0.83, 95% CI, 0.51 to 1.34). Women with gestational hypertension had 2.33 (95% CI, 0.99 to 5.50) times the risk of women with no history of Hypertensive Disorders of Pregnancy, an inverse association was observed between preeclampsia and cardiovascular diseases (OR = 0.28, 95% CI, 0.10 to 0.72). Conclusions: Cameroonian women with a history of gestational hypertension may have an increased risk of cardiovascular diseases. However, population-based studies with more accurate data on the exposure are needed.

scholarly journals Long-Term Cardiovascular Disease Risk in Women After Hypertensive Disorders of Pregnancy: Recent Advances in Hypertension

Hypertension ◽  
2021 ◽  
Author(s):  
Kavia Khosla ◽  
Sarah Heimberger ◽  
Kristin M. Nieman ◽  
Avery Tung ◽  
Sajid Shahul ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Risk Reduction ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Hypertensive Disorders Of Pregnancy ◽  
Cardiovascular Risk Reduction ◽  
Hypertensive Disorders ◽  
History Of

Patients with a history of hypertensive disorders of pregnancy (HDP) suffer higher rates of long-term cardiovascular events including heart failure, coronary artery disease, and stroke. Cardiovascular changes during pregnancy can act as a natural stress test, subsequently unmasking latent cardiovascular disease in the form of HDP. Because HDP now affect 10% of pregnancies in the United States, the American Heart Association has called for physicians who provide peripartum care to promote early identification and cardiovascular risk reduction. In this review, we discuss the epidemiology, pathophysiology, and outcomes of HDP-associated cardiovascular disease. In addition, we propose a multi-pronged approach to support cardiovascular risk reduction for women with a history of HDP. Additional research is warranted to define appropriate blood pressure targets in the postpartum period, optimize the use of pregnancy history in risk stratification tools, and clarify the effectiveness of preventive interventions. The highest rates of HDP are in populations with poor access to resources and quality health care, making it a major risk for inequity of care. Interventions to decrease long-term cardiovascular disease risk in women following HDP must also target disparity reduction.

scholarly journals Hypertensive Disorders of Pregnancy and Risk of Cardiovascular Disease-Related Morbidity and Mortality: A Systematic Review and Meta-Analysis

Cardiology ◽  
2020 ◽  
Vol 145 (10) ◽  
pp. 633-647
Author(s):  
Rong Wu ◽  
Tingting Wang ◽  
Runhui Gu ◽  
Dexiu Xing ◽  
Changxiang Ye ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Reference Group ◽  
Morbidity And Mortality ◽  
Significant Heterogeneity ◽  
Hypertensive Disorders Of Pregnancy ◽  
Case Control Studies ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
History Of ◽  
Related Mortality

Introduction: Several studies have demonstrated that there is a higher risk of cardiovascular disease (CVD) in women with a history of hypertensive disorders of pregnancy (HDP). However, effect sizes varied greatly between these studies, and a complete overview of the existing data in the literature is lacking. We aimed to evaluate the association between HDP and the risk of CVD-related morbidity and mortality. Methods: Systematic literature searches were conducted in several electronic databases from inception to July 2019. Exposure of interest was any type of HDP. Outcomes of interest included any CVD, CVD-related mortality, and hypertension. Results: Sixty-six cohort and 7 case-control studies involving >13 million women were included. The overall combined relative risks (RRs) for women with a history of HDP compared with the reference group were 1.80 (95% confidence interval [CI] 1.67–1.94) for any CVD, 1.66 (1.49–1.84) for coronary artery heart disease, 2.87 (2.14–3.85) for heart failure, 1.60 (1.29–2.00) for peripheral vascular disease, 1.72 (1.50–1.97) for stroke, 1.78 (1.58–2.00) for CVD-related mortality, and 3.16 (2.74–3.64) for hypertension. Significant heterogeneity was partially explained by all or part of the variables including type of exposure, follow-up time, geographic region, and sample source. Conclusions: Women with a history of HDP are at an increased risk of future CVD-related morbidity and mortality. Our study highlights the importance of life-long monitoring of cardiovascular risk factors in women with a history of HDP.

scholarly journals Awareness of obstetricians for long-term risks in women with a history of preeclampsia or HELLP syndrome

2021 ◽  
Author(s):  
Pilar Palmrich ◽  
Carina Binder ◽  
Harald Zeisler ◽  
Bettina Kroyer ◽  
Petra Pateisky ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Renal Disease ◽  
Hellp Syndrome ◽  
Hypertensive Disorders Of Pregnancy ◽  
Risk Of Recurrence ◽  
Hypertensive Disorders ◽  
Follow Up Care ◽  
History Of

Abstract Purpose Hypertensive disorders of pregnancy are still a leading cause of maternal and neonatal morbidity and mortality worldwide. Women with a history of preeclampsia have an increased risk for future cardiovascular and cerebrovascular disease, renal disease as well as diabetes mellitus. There is little knowledge on postpartum risk management. The aim of this study was to assess follow-up care for patients after pre-eclampsia or HELLP syndrome. Methods This questionnaire-based cross-sectional study aimed to evaluate the current recommendations of obstetricians in Austria regarding follow-up care, long-term risk counselling and risk of recurrence in future pregnancies after preeclampsia or HELLP syndrome. Data were collected using a survey, based on recommendations given by three substantial guidelines on hypertensive disorders of pregnancy, which was distributed via e-mail to 69 public obstetric departments in Austria. Each obstetric department was required to answer one questionnaire per local protocol. Results Our results revealed that of the 48 participating hospitals most obstetricians are aware of the importance of follow-up care for women after a pregnancy complicated by preeclampsia. Our data show that most physicians counselled patients about the future cardiovascular health risks associated with preeclampsia or HELLP syndrome (79.2%). Most obstetricians recommended lifestyle modification (77.1%) and continued blood pressure measurements (97.9%). All centers stated to counsel about the risk of recurrence (100%). However, counselling regarding follow-up care to exclude kidney damage (37.5%) and underlying diseases like thrombophilia (39.6%) were less prioritized. Conclusions We were able to show that counselling concerning the risk of long-term cardiovascular disease and risk of recurrence after a pregnancy complicated by preeclampsia or HELLP syndrome has been established in obstetric departments in public hospitals. Regarding the evaluation of underlying chronic diseases such as thrombophilia or renal disease, as well as counselling on the future risk of renal disease is still improvable according to our data. Further evaluation of follow-up care after hypertensive disorders of pregnancy in the outpatient and private sector and implementation of structured guidelines for follow-up, as well as screening for cardiovascular disease are necessary to ensure adequate risk management and to provide opportunities for prevention.

scholarly journals Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study

BMJ ◽  
2017 ◽  
pp. j3078 ◽  
Author(s):  
Ida Behrens ◽  
Saima Basit ◽  
Mads Melbye ◽  
Jacob A Lykke ◽  
Jan Wohlfahrt ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hypertensive Disorders Of Pregnancy ◽  
Pregnancy Hypertension ◽  
Hypertensive Disorders ◽  
History Of

Abstract 16725: Family History of Cardiovascular Disease is an Independent Predictor of Gestational Hypertensive Disease and Diabetes: The Korean Nurses’ Survey

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Heesun Lee ◽  
Chang-Hwan Yoon ◽  
Hyun-Young Park ◽  
Hea Young Lee ◽  
Dong-Ju Choi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Family History ◽  
Gestational Diabetes ◽  
Medical Knowledge ◽  
Multivariate Logistic Regression Analysis ◽  
Computer Assisted ◽  
Hypertensive Disease ◽  
Medical Disorders ◽  
Hypertensive Disorders ◽  
History Of

Background: Gestational hypertensive disorders and diabetes are well-known to increase the risk of cardiovascular disease (CVD) and diabetes later in life. However, there were few researches to evaluate the association between family history of cardiovascular disease and the occurrence of pregnancy-related medical disorders. We aimed to investigate whether family history of CVD could predict gestational hypertensive disorders and diabetes. Methods: The Korean Nurses’ Survey was conducted through web-based computer-assisted self-administered questionnaires, which were compiled by consultation to cardiologists, gynecologists, and statisticians, from October to December 2011. We enrolled a total of 9,989 female registered nurses who could answer reliably the questionnaires based on their medical knowledge. Multivariate logistic regression analysis was used to clarify the effect of family history of CVD on pregnancy-related medical disorders. Result: In this survey, 3900 subjects had more than 1 pregnancy. Among them, 247 interviewees (6.3%) had experienced hypertensive disorders during pregnancy, which included preeclampsia (n = 160, 4.1%) and transient hypertension (n = 144, 3.7%), and 120 (3.1%) had experienced gestational diabetes. And, 2872 subjects (73.6%) answered that they had at least 1 family history of CVD. Having family history of CVD increased the risk of gestational hypertensive disorders (adjusted RR 1.51, 95% CI 1.08-2.11, p = 0.015) and diabetes (adjusted RR 2.40, 95% CI 1.38-4.17, p = 0.002). In particular, family history of hypertension was significantly associated with gestational hypertensive disorders (adjusted RR 2.00, 95% CI 1.47-2.50, p <0.001), and diabetes was highly related with gestational diabetes (adjusted RR 3.37, 95% CI 2.35-4.83, p <0.001), respectively. Furthermore, this relationship was observed regardless of maternal parity. Conclusion: Family history of CVD was a significant predictor of pregnancy-related medical disorders in this survey. Meticulous history taking for family history of CVD can provide the risk of gestational hypertensive disease and diabetes. Thus, special attention should be paid to women with family history of CVD during pregnancy.

Cardiovascular risk model performance in women with and without hypertensive disorders of pregnancy

Heart ◽  
2018 ◽  
Vol 105 (4) ◽  
pp. 330-336 ◽  
Author(s):  
Veerle Dam ◽  
N Charlotte Onland-Moret ◽  
W M Monique Verschuren ◽  
Jolanda M A Boer ◽  
Laura Benschop ◽  
...  
Keyword(s):  
Risk Model ◽  
Model Performance ◽  
Predictive Performance ◽  
Baseline Risk ◽  
Hypertensive Disorders Of Pregnancy ◽  
Cvd Risk ◽  
Hypertensive Disorders ◽  
Framingham Risk ◽  
History Of ◽  
Score Model

ObjectivesCompare the predictive performance of Framingham Risk Score (FRS), Pooled Cohort Equations (PCEs) and Systematic COronary Risk Evaluation (SCORE) model between women with and without a history of hypertensive disorders of pregnancy (hHDP) and determine the effects of recalibration and refitting on predictive performance.MethodsWe included 29 751 women, 6302 with hHDP and 17 369 without. We assessed whether models accurately predicted observed 10-year cardiovascular disease (CVD) risk (calibration) and whether they accurately distinguished between women developing CVD during follow-up and not (discrimination), separately for women with and without hHDP. We also recalibrated (updating intercept and slope) and refitted (recalculating coefficients) the models.ResultsOriginal FRS and PCEs overpredicted 10-year CVD risks, with expected:observed (E:O) ratios ranging from 1.51 (for FRS in women with hHDP) to 2.29 (for PCEs in women without hHDP), while E:O ratios were close to 1 for SCORE. Overprediction attenuated slightly after recalibration for FRS and PCEs in both hHDP groups. Discrimination was reasonable for all models, with C-statistics ranging from 0.70-0.81 (women with hHDP) and 0.72–0.74 (women without hHDP). C-statistics improved slightly after refitting 0.71–0.83 (with hHDP) and 0.73–0.80 (without hHDP). The E:O ratio of the original PCE model was statistically significantly better in women with hHDP compared with women without hHDP.ConclusionsSCORE performed best in terms of both calibration and discrimination, while FRS and PCEs overpredicted risk in women with and without hHDP, but improved after recalibrating and refitting the models. No separate model for women with hHDP seems necessary, despite their higher baseline risk.

scholarly journals Annual body mass index gain and risk of hypertensive disorders of pregnancy in a subsequent pregnancy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sho Tano ◽  
Tomomi Kotani ◽  
Takafumi Ushida ◽  
Masato Yoshihara ◽  
Kenji Imai ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Body Mass ◽  
Body Weight Gain ◽  
Subsequent Pregnancy ◽  
The Body ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Age Related ◽  
History Of

AbstractWeight gain during interpregnancy period is related to hypertensive disorders of pregnancy (HDP). However, in interpregnancy care/counseling, the unpredictability of the timing of the next conception and the difficulties in preventing age-related body weight gain must be considered while setting weight management goals. Therefore, we suggest considering the annual change in the body mass index (BMI). This study aimed to clarify the association between annual BMI changes during the interpregnancy period and HDP risk in subsequent pregnancies. A multicenter retrospective study of data from 2009 to 2019 examined the adjusted odds ratio (aOR) of HDP in subsequent pregnancies. The aORs in several annual BMI change categories were also calculated in the subgroups classified by HDP occurrence in the index pregnancy. This study included 1,746 pregnant women. A history of HDP (aOR, 16.76; 95% confidence interval [CI], 9.62 − 29.22), and annual BMI gain (aOR, 2.30; 95% CI, 1.76 − 3.01) were independent risk factors for HDP in subsequent pregnancies. An annual BMI increase of ≥ 1.0 kg/m2/year was related to HDP development in subsequent pregnancies for women without a history of HDP. This study provides data as a basis for interpregnancy care/counseling, but further research is necessary to validate our findings and confirm this relationship.

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