Preeclampsia Brings the Risk of Premature Cardiovascular Disease in Women Closer to That of Men.

Autor: Langlois AWR; Queen's University, Kingston, Ontario, Canada., Park AL; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada., Lentz EJM; Department of Medicine, McMaster University, Hamilton, Ontario, Canada., Ray JG; Departments of Medicine, Health Policy Management and Evaluation, and Obstetrics and Gynecology, St Michael's Hospital, Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada. Electronic address: rayj@smh.ca.
Jazyk: angličtina
Zdroj: The Canadian journal of cardiology [Can J Cardiol] 2020 Jan; Vol. 36 (1), pp. 60-68. Date of Electronic Publication: 2019 Jul 11.
DOI: 10.1016/j.cjca.2019.06.028
Abstrakt: Background: It is not known if sex differences in the risk of premature cardiovascular disease (CVD) vary by whether a woman had preeclampsia or not. The current study determined whether prior preeclampsia brings a woman's risk of CVD closer to that of a male counterpart.
Methods: A population-based cohort study was completed in Ontario, Canada, from 1993 to 2017. Participants were 55,186 women with prior preeclampsia, 110,372 randomly selected age- and region-matched men, and 110,372 similarly selected women who gave birth without prior preeclampsia. The primary outcome was a CVD composite outcome of any hospitalization or revascularization for coronary artery disease, cerebrovascular disease, peripheral artery disease, heart failure, and dysrhythmia.
Results: Median follow-up was approximately 16 years. Relative to women without prior preeclampsia (1193 events; 7.5 per 10,000 person-years), men had the highest risk of CVD (3706 events; 24.3 per 10,000 person-years) (adjusted hazard ratio [aHR], 2.52; 95% confidence interval [CI], 2.35-2.69). Women with a history of preeclampsia were also at higher risk (1252 events; 16.0 per 10,000 person-years) (aHR, 1.17; 95% CI, 1.08-1.28). Women with preeclampsia requiring preterm delivery were even more likely to experience CVD (21.5 per 10,000 person-years) (aHR, 1.44; 95% CI, 1.18-1.76). The absolute risk of CVD in men (22.5 per 10,000 person-years) was similar to the risk in women with preeclampsia and preterm delivery, but men had the highest aHR (2.48; 95% CI, 2.11-2.93).
Conclusions: Although men remain at significantly higher risk of CVD, a history of preeclampsia, especially with preterm birth, elevates a woman's risk closer to that of a man.
(Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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