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Functional and structural vascular biomarkers in women 1 year after a hypertensive disorder of pregnancy
- Source :
- Pregnancy Hypertension. 21:23-29
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Objectives Women with a previous hypertensive disorder of pregnancy (HDP: gestational hypertension and preeclampsia) have increased long-term cardiovascular disease risk. Recent meta-analyses show adverse levels of non-invasive functional and structural cardiovascular risk markers such as pulse wave velocity (PWV), heart-rate adjusted augmentation index (AIx75), carotid intima-media thickness (CIMT), and reactive hyperemia index (RHI) after HDPs, and suggest using these for cardiovascular risk stratification. However, it is not known if a previous HDP predict levels of these markers beyond classical cardiovascular risk factors. Study design and main outcome measures. We assessed PWV, AIx75, CIMT, RHI, classical cardiovascular risk factors, and pregnancy characteristics in 221 women 1 year postpartum (controls: 95, previous HDP: 126). Uni- and multi- variate regression analysis were conducted to assess associations between previous HDP and PWV, AIx75, CIMT or RHI. We adjusted for classical cardiovascular risk factors and pregnancy characteristics. A p-level Results PWV was associated with previous HDP on univariate analysis. This effect was confounded by blood pressure and not significant after adjustment. We found no significant associations between AIx75, RHI, CIMT, and a previous HDP, neither before nor after adjustments. Conclusions Associations between a previous HDP and PWV, AIx75, CIMT, or RHI 1 year postpartum can largely be explained by adverse levels of classical cardiovascular risk markers in women with a previous HDP. Women with previous HDP should receive primary prevention of cardiovascular disease, but PWV, AIx75, CIMT or RHI are unlikely to aid in cardiovascular risk stratification 1 year postpartum.
- Subjects :
- Adult
Gestational hypertension
medicine.medical_specialty
Hyperemia
Disease
Pulse Wave Analysis
030204 cardiovascular system & hematology
Carotid Intima-Media Thickness
Risk Assessment
Preeclampsia
03 medical and health sciences
0302 clinical medicine
Pre-Eclampsia
Heart Rate
Pregnancy
Internal medicine
Internal Medicine
medicine
Humans
Prospective Studies
cardiovascular diseases
Reactive hyperemia
Pulse wave velocity
Univariate analysis
030219 obstetrics & reproductive medicine
business.industry
Obstetrics and Gynecology
medicine.disease
Diabetes, Gestational
Blood pressure
Heart Disease Risk Factors
Case-Control Studies
cardiovascular system
Cardiology
Female
business
Biomarkers
Subjects
Details
- ISSN :
- 22107789
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- Pregnancy Hypertension
- Accession number :
- edsair.doi.dedup.....3cb84de3bbfbeb194a42390bd8802c93