Hypertensive Disorders of Pregnancy and Cardiovascular Diseases: Current Knowledge and Future Directions

Purpose of the review Cardiovascular diseases (CVDs) are the principal killers of women. In this review, we summarize data regarding CVD and mortality after hypertensive disorders of pregnancy (HDP), and highlight clinical, research and policy needs to mitigate this risk. Recent findings Robust data...

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Vydané v:	Current treatment options in cardiovascular medicine Ročník 20; číslo 7; s. 56
Hlavní autori:	Coutinho, Thais, Lamai, Olabimpe, Nerenberg, Kara
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	New York Springer US 01.07.2018 Springer Nature B.V
Predmet:	Atherosclerosis Body mass index Cardiology Cardiovascular disease Diabetes Disease prevention Eclampsia Exercise Health risks Heart failure Hemodynamics Hypertension Lifestyles Medicine Medicine & Public Health Mortality Pathophysiology Population-based studies Preeclampsia Pregnancy Pregnancy and Cardiovascular Disease (N Scott Public health Section Editor Topical Collection on Pregnancy and Cardiovascular Disease Womens health Myocardial infarction Heart failure Cardiovascular disease Stroke Preeclampsia Hypertensive disorders of pregnancy
ISSN:	1092-8464, 1534-3189
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Abstract	Purpose of the review Cardiovascular diseases (CVDs) are the principal killers of women. In this review, we summarize data regarding CVD and mortality after hypertensive disorders of pregnancy (HDP), and highlight clinical, research and policy needs to mitigate this risk. Recent findings Robust data indicate that women with HDP have substantially higher risk of future CVD, with a 3.7-fold increase in the risk of chronic hypertension, a 4.2-fold increase in the risk of heart failure, an 81% increase in the risk of stroke, and double the risk of atrial arrhythmias, coronary heart disease, and mortality when compared to women with normotensive pregnancies. Potential explanations include (1) the effect of pregnancy as a “stress test” in women destined to develop CVD, (2) mediation by conventional risk factors, (3) long-term vascular damage sustained during the preeclamptic episode, and (4) preexisting abnormalities in arterial health predisposing women to HDP, and, subsequently, CVD. Summary Women with HDP have significantly increased risk of CVD and mortality. Risk scores including obstetric history are necessary to better estimate a woman’s cardiovascular risk. In addition, comprehensive policies promoting systematic risk assessment and modification after HDP are critically needed to improve health, wellness, and survival of affected women.
AbstractList	Purpose of the review Cardiovascular diseases (CVDs) are the principal killers of women. In this review, we summarize data regarding CVD and mortality after hypertensive disorders of pregnancy (HDP), and highlight clinical, research and policy needs to mitigate this risk. Recent findings Robust data indicate that women with HDP have substantially higher risk of future CVD, with a 3.7-fold increase in the risk of chronic hypertension, a 4.2-fold increase in the risk of heart failure, an 81% increase in the risk of stroke, and double the risk of atrial arrhythmias, coronary heart disease, and mortality when compared to women with normotensive pregnancies. Potential explanations include (1) the effect of pregnancy as a “stress test” in women destined to develop CVD, (2) mediation by conventional risk factors, (3) long-term vascular damage sustained during the preeclamptic episode, and (4) preexisting abnormalities in arterial health predisposing women to HDP, and, subsequently, CVD. Summary Women with HDP have significantly increased risk of CVD and mortality. Risk scores including obstetric history are necessary to better estimate a woman’s cardiovascular risk. In addition, comprehensive policies promoting systematic risk assessment and modification after HDP are critically needed to improve health, wellness, and survival of affected women. Purpose of the reviewCardiovascular diseases (CVDs) are the principal killers of women. In this review, we summarize data regarding CVD and mortality after hypertensive disorders of pregnancy (HDP), and highlight clinical, research and policy needs to mitigate this risk.Recent findingsRobust data indicate that women with HDP have substantially higher risk of future CVD, with a 3.7-fold increase in the risk of chronic hypertension, a 4.2-fold increase in the risk of heart failure, an 81% increase in the risk of stroke, and double the risk of atrial arrhythmias, coronary heart disease, and mortality when compared to women with normotensive pregnancies. Potential explanations include (1) the effect of pregnancy as a “stress test” in women destined to develop CVD, (2) mediation by conventional risk factors, (3) long-term vascular damage sustained during the preeclamptic episode, and (4) preexisting abnormalities in arterial health predisposing women to HDP, and, subsequently, CVD.SummaryWomen with HDP have significantly increased risk of CVD and mortality. Risk scores including obstetric history are necessary to better estimate a woman’s cardiovascular risk. In addition, comprehensive policies promoting systematic risk assessment and modification after HDP are critically needed to improve health, wellness, and survival of affected women. Cardiovascular diseases (CVDs) are the principal killers of women. In this review, we summarize data regarding CVD and mortality after hypertensive disorders of pregnancy (HDP), and highlight clinical, research and policy needs to mitigate this risk.PURPOSE OF THE REVIEWCardiovascular diseases (CVDs) are the principal killers of women. In this review, we summarize data regarding CVD and mortality after hypertensive disorders of pregnancy (HDP), and highlight clinical, research and policy needs to mitigate this risk.Robust data indicate that women with HDP have substantially higher risk of future CVD, with a 3.7-fold increase in the risk of chronic hypertension, a 4.2-fold increase in the risk of heart failure, an 81% increase in the risk of stroke, and double the risk of atrial arrhythmias, coronary heart disease, and mortality when compared to women with normotensive pregnancies. Potential explanations include (1) the effect of pregnancy as a "stress test" in women destined to develop CVD, (2) mediation by conventional risk factors, (3) long-term vascular damage sustained during the preeclamptic episode, and (4) preexisting abnormalities in arterial health predisposing women to HDP, and, subsequently, CVD. Women with HDP have significantly increased risk of CVD and mortality. Risk scores including obstetric history are necessary to better estimate a woman's cardiovascular risk. In addition, comprehensive policies promoting systematic risk assessment and modification after HDP are critically needed to improve health, wellness, and survival of affected women.RECENT FINDINGSRobust data indicate that women with HDP have substantially higher risk of future CVD, with a 3.7-fold increase in the risk of chronic hypertension, a 4.2-fold increase in the risk of heart failure, an 81% increase in the risk of stroke, and double the risk of atrial arrhythmias, coronary heart disease, and mortality when compared to women with normotensive pregnancies. Potential explanations include (1) the effect of pregnancy as a "stress test" in women destined to develop CVD, (2) mediation by conventional risk factors, (3) long-term vascular damage sustained during the preeclamptic episode, and (4) preexisting abnormalities in arterial health predisposing women to HDP, and, subsequently, CVD. Women with HDP have significantly increased risk of CVD and mortality. Risk scores including obstetric history are necessary to better estimate a woman's cardiovascular risk. In addition, comprehensive policies promoting systematic risk assessment and modification after HDP are critically needed to improve health, wellness, and survival of affected women. Cardiovascular diseases (CVDs) are the principal killers of women. In this review, we summarize data regarding CVD and mortality after hypertensive disorders of pregnancy (HDP), and highlight clinical, research and policy needs to mitigate this risk. Robust data indicate that women with HDP have substantially higher risk of future CVD, with a 3.7-fold increase in the risk of chronic hypertension, a 4.2-fold increase in the risk of heart failure, an 81% increase in the risk of stroke, and double the risk of atrial arrhythmias, coronary heart disease, and mortality when compared to women with normotensive pregnancies. Potential explanations include (1) the effect of pregnancy as a "stress test" in women destined to develop CVD, (2) mediation by conventional risk factors, (3) long-term vascular damage sustained during the preeclamptic episode, and (4) preexisting abnormalities in arterial health predisposing women to HDP, and, subsequently, CVD. Women with HDP have significantly increased risk of CVD and mortality. Risk scores including obstetric history are necessary to better estimate a woman's cardiovascular risk. In addition, comprehensive policies promoting systematic risk assessment and modification after HDP are critically needed to improve health, wellness, and survival of affected women.
ArticleNumber	56
Author	Lamai, Olabimpe Coutinho, Thais Nerenberg, Kara
Author_xml	– sequence: 1 givenname: Thais surname: Coutinho fullname: Coutinho, Thais email: tcoutinho@ottawaheart.ca organization: Canadian Women’s Heart Health Centre, University of Ottawa Heart Institute, Division of Cardiac Prevention & Rehabilitation, University of Ottawa Heart Institute, Division of Cardiology, University of Ottawa Heart Institute – sequence: 2 givenname: Olabimpe surname: Lamai fullname: Lamai, Olabimpe organization: Division of Cardiology, University of Ottawa Heart Institute – sequence: 3 givenname: Kara surname: Nerenberg fullname: Nerenberg, Kara organization: Departments of Medicine, Obstetrics & Gynecology and Community Health Sciences, Cumming School of Medicine, University of Calgary
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Keywords	Myocardial infarction Heart failure Cardiovascular disease Stroke Preeclampsia Hypertensive disorders of pregnancy
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PublicationTitle	Current treatment options in cardiovascular medicine
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Snippet	Purpose of the review Cardiovascular diseases (CVDs) are the principal killers of women. In this review, we summarize data regarding CVD and mortality after... Cardiovascular diseases (CVDs) are the principal killers of women. In this review, we summarize data regarding CVD and mortality after hypertensive disorders... Purpose of the reviewCardiovascular diseases (CVDs) are the principal killers of women. In this review, we summarize data regarding CVD and mortality after...
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SubjectTerms	Atherosclerosis Body mass index Cardiology Cardiovascular disease Diabetes Disease prevention Eclampsia Exercise Health risks Heart failure Hemodynamics Hypertension Lifestyles Medicine Medicine & Public Health Mortality Pathophysiology Population-based studies Preeclampsia Pregnancy Pregnancy and Cardiovascular Disease (N Scott Public health Section Editor Topical Collection on Pregnancy and Cardiovascular Disease Womens health
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Title	Hypertensive Disorders of Pregnancy and Cardiovascular Diseases: Current Knowledge and Future Directions
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