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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Vydáno v:Current treatment options in cardiovascular medicine Ročník 20; číslo 7; s. 56
Hlavní autoři: Coutinho, Thais, Lamai, Olabimpe, Nerenberg, Kara
Médium: Journal Article
Jazyk:angličtina
Vydáno: New York Springer US 01.07.2018
Springer Nature B.V
Témata:
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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Shrnutí: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.
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ISSN:1092-8464
1534-3189
DOI:10.1007/s11936-018-0653-8