Postpartum evaluation of cardiovascular disease risk for women with pregnancies complicated by hypertension

Autor: Lucy C Chappell, Fiona Broughton Pipkin, Daniele Cristovao Escouto, Lesia O. Kurlak, Pamela Loughna, Kate Bramham, Kate F. Walker, Amanda Green
Rok vydání: 2018
Předmět:
Gestational hypertension
Time Factors
Blood Pressure
Disease
030204 cardiovascular system & hematology
Kidney
0302 clinical medicine
Pre-Eclampsia
Pregnancy
Risk Factors
Natriuretic Peptide
Brain
Natriuretic peptide
030212 general & internal medicine
Longitudinal Studies
Prospective Studies
reproductive and urinary physiology
Framingham Risk Score
Obstetrics
Postpartum Period
Obstetrics and Gynecology
Cardiovascular disease
Prognosis
Parity
Pregnancy-induced hypertension
England
Cardiovascular Diseases
Blood pressure
Biomarker (medicine)
Female
Glomerular Filtration Rate
Adult
medicine.medical_specialty
medicine.drug_class
Renal function
Black People
Risk Assessment
03 medical and health sciences
Young Adult
Lipocalin-2
Postpartum
Predictive Value of Tests
Internal Medicine
medicine
Humans
Endothelium
Placenta Growth Factor
business.industry
Hypertension
Pregnancy-Induced
medicine.disease
business
Pre-eclampsia
Biomarkers
Zdroj: Escouto, D C, Green, A, Kurlak, L, Walker, K, Loughna, P, Chappell, L, Pipkin, F B & Bramham, K 2018, ' Postpartum Evaluation of Cardiovascular Disease Risk for Women with Pregnancies Complicated by Hypertension ', Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health . https://doi.org/10.1016/j.preghy.2018.06.019
ISSN: 2210-7797
2210-7789
DOI: 10.1016/j.preghy.2018.06.019
Popis: Objectives Postpartum stratification of cardiovascular risk for women with pregnancies complicated by pre-eclampsia is challenging. Our aim was to identify potential clinical and biomarker predictors of future cardiovascular risk at six weeks postpartum in women with hypertensive pregnancies. Study design: Prospective longitudinal cohort Main outcome measures Ten year- Framingham cardiovascular risk scores were calculated for 477 women (94 with gestational hypertension, 288 with pre-eclampsia, 30 with superimposed pre-eclampsia, 51 with chronic hypertension, 14 women with uncomplicated pregnancies). B-type natriuretic peptide (BNP), neutrophil gelatinase–associated lipocalin (NGAL) and placental growth factor (PlGF) were quantified at six weeks postpartum. Results Framingham cardiovascular risk scores were not higher in women with pregnancies complicated by pre-eclampsia than healthy controls, nor were scores higher in women with pre-existing chronic hypertension complicated with superimposed pre-eclampsia compared with those without superimposed pre-eclampsia. Women with gestational hypertension had higher risk scores than women with pre-eclampsia and healthy controls. Established risk factors of cardiovascular disease including diastolic blood pressure and previously diagnosed chronic hypertension were associated with higher scores, and African ethnicity, parity and estimated glomerular filtration rate also were independently associated with higher Framingham risk scores at six weeks postpartum. PlGF, BNP and NGAL concentrations were not associated with Framingham cardiovascular risk scores after adjustment for independent variables. Conclusions A history of pre-eclampsia or superimposed pre-eclampsia in most recent pregnancy was not associated with elevated Framingham risk score at six weeks postpartum. Established clinical predictors may enable risk stratification at six weeks postpartum, which are not enhanced by the biomarkers included in this study.
Databáze: OpenAIRE
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