Eur Heart J:妊娠高血压疾病与慢性高血压的关系

2021-10-15 MedSci原创 MedSci原创

妊娠期高血压疾病在分娩后的头几年大大增加了慢性高血压的风险。

妊娠期高血压疾病(HDP)是孕产妇和胎儿发病率和死亡率的主要原因。

近日,血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员旨在评估HDP对初产妇分娩后头几年慢性高血压发病的影响。

这项全国性队列研究使用了法国国家健康数据系统(SNDS)的数据,纳入了所有在2010年至2018年期间分娩且既往没有慢性高血压的初产妇女。从产后6周开始对妇女进行随访,直到出现高血压、心血管事件、死亡或研究结束日期(2018年12月31日)。该研究的主要结局是慢性高血压的诊断。研究人员使用Cox模型来估计所有类型HDP的慢性高血压风险比(HR)。

该研究总共有2663573名女性被纳入,平均随访时间为3.0年。其中,180063名(6.73%)患者伴有HDP。具体而言,66260名(2.16%)患者伴有先兆子痫(PE),113803名(4.27%)患者伴有妊娠期高血压(GH)。与没有HDP的女性相比,对于GH、PE、早期PE、严重PE和GH后的PE经完全调整后的慢性高血压HR分别为6.03[95%置信区间(CI)5.89-6.17]、8.10(95%CI为7.88-8.33)、12.95(95%CI为12.29-13.65)、严重PE为9.90(95%CI为9.53-10.28)和13.17(95%CI为12.74-13.60)。妊娠暴露持续时间的高血压疾病是所有PE亚组慢性高血压的另一个危险因素。伴有HDP的女性更频繁和更早地咨询全科医生或心脏病专家。

由此可见,妊娠期高血压疾病在分娩后的头几年大大增加了慢性高血压的风险。

原始出处:

Pauline Boucheron.et al.Hypertensive disorders of pregnancy and onset of chronic hypertension in France: the nationwide CONCEPTION study.European Heart Journal.2021.https://academic.oup.com/eurheartj/advance-articles

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    2021-12-01 ms9000001665482523

    学习了

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    赞同

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    2021-10-17 zhaojie88
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createdBy=80d715270048, createdName=slcumt, createdTime=Sun Oct 17 14:33:23 CST 2021, time=2021-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061138, encodeId=754b1061138af, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sat Oct 16 23:54:21 CST 2021, time=2021-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060965, encodeId=94f51060965b8, content=这种疾病的治疗,应该尽早联合中医药。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/02/16/0faa103465b91b9063acb537ef1b1b3d.jpg, createdBy=a2fe5280621, createdName=默拜岐黄, 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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Oct 16 08:55:28 CST 2021, time=2021-10-16, status=1, ipAttribution=)]
  5. 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style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Oct 17 14:33:23 CST 2021, time=2021-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492013, encodeId=3d1014920135e, content=<a href='/topic/show?id=4ff54492941' target=_blank style='color:#2F92EE;'>#妊娠高血压疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44929, encryptionId=4ff54492941, topicName=妊娠高血压疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6bb88907518, createdName=zhangjiqing, createdTime=Sun Oct 17 14:33:23 CST 2021, time=2021-10-17, status=1, ipAttribution=), 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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Oct 16 08:55:28 CST 2021, time=2021-10-16, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1075638, encodeId=449310e563891, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ca806157454, createdName=ms9000001665482523, createdTime=Wed Dec 01 00:29:43 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061691, encodeId=659110616913a, content=赞同, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11245485718, createdName=ms4000000508774213, createdTime=Tue Oct 19 07:35:41 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357809, encodeId=6c28135e809aa, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Oct 17 14:33:23 CST 2021, time=2021-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492013, encodeId=3d1014920135e, content=<a href='/topic/show?id=4ff54492941' target=_blank style='color:#2F92EE;'>#妊娠高血压疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44929, encryptionId=4ff54492941, topicName=妊娠高血压疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6bb88907518, createdName=zhangjiqing, createdTime=Sun Oct 17 14:33:23 CST 2021, time=2021-10-17, status=1, ipAttribution=), 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createdBy=80d715270048, createdName=slcumt, createdTime=Sun Oct 17 14:33:23 CST 2021, time=2021-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061138, encodeId=754b1061138af, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sat Oct 16 23:54:21 CST 2021, time=2021-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060965, encodeId=94f51060965b8, content=这种疾病的治疗,应该尽早联合中医药。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/02/16/0faa103465b91b9063acb537ef1b1b3d.jpg, createdBy=a2fe5280621, createdName=默拜岐黄, createdTime=Sat Oct 16 09:57:55 CST 2021, time=2021-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060963, encodeId=f9b010609633a, content=从中医理论来讲,妊娠高血压有很大一部分属于“肝肾亏虚”,引起肝风内动,这类型的高血压是可以预防并且方子根治的。只是怀孕引发了肝风内动,也就是引发了妊娠高血压,而这个病因其实从中医理论来讲,是可以预防的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/02/16/0faa103465b91b9063acb537ef1b1b3d.jpg, createdBy=a2fe5280621, createdName=默拜岐黄, createdTime=Sat Oct 16 09:56:18 CST 2021, time=2021-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060944, encodeId=bdd3106094427, content=这项全国性队列研究使用了法国国家健康, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Oct 16 08:55:28 CST 2021, time=2021-10-16, status=1, ipAttribution=)]
    2021-10-17 slcumt
  7. 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createdTime=Sat Oct 16 09:57:55 CST 2021, time=2021-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060963, encodeId=f9b010609633a, content=从中医理论来讲,妊娠高血压有很大一部分属于“肝肾亏虚”,引起肝风内动,这类型的高血压是可以预防并且方子根治的。只是怀孕引发了肝风内动,也就是引发了妊娠高血压,而这个病因其实从中医理论来讲,是可以预防的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/02/16/0faa103465b91b9063acb537ef1b1b3d.jpg, createdBy=a2fe5280621, createdName=默拜岐黄, createdTime=Sat Oct 16 09:56:18 CST 2021, time=2021-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060944, encodeId=bdd3106094427, content=这项全国性队列研究使用了法国国家健康, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Oct 16 08:55:28 CST 2021, time=2021-10-16, status=1, ipAttribution=)]
    2021-10-16 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

  8. 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createdTime=Sat Oct 16 09:57:55 CST 2021, time=2021-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060963, encodeId=f9b010609633a, content=从中医理论来讲,妊娠高血压有很大一部分属于“肝肾亏虚”,引起肝风内动,这类型的高血压是可以预防并且方子根治的。只是怀孕引发了肝风内动,也就是引发了妊娠高血压,而这个病因其实从中医理论来讲,是可以预防的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/02/16/0faa103465b91b9063acb537ef1b1b3d.jpg, createdBy=a2fe5280621, createdName=默拜岐黄, createdTime=Sat Oct 16 09:56:18 CST 2021, time=2021-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060944, encodeId=bdd3106094427, content=这项全国性队列研究使用了法国国家健康, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Oct 16 08:55:28 CST 2021, time=2021-10-16, status=1, ipAttribution=)]
    2021-10-16 默拜岐黄

    这种疾病的治疗,应该尽早联合中医药。

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1075638, encodeId=449310e563891, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ca806157454, createdName=ms9000001665482523, createdTime=Wed Dec 01 00:29:43 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061691, encodeId=659110616913a, content=赞同, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11245485718, createdName=ms4000000508774213, createdTime=Tue Oct 19 07:35:41 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357809, encodeId=6c28135e809aa, content=<a href='/topic/show?id=b0702e84b9' target=_blank 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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Oct 16 08:55:28 CST 2021, time=2021-10-16, status=1, ipAttribution=)]
    2021-10-16 默拜岐黄

    从中医理论来讲,妊娠高血压有很大一部分属于“肝肾亏虚”,引起肝风内动,这类型的高血压是可以预防并且方子根治的。只是怀孕引发了肝风内动,也就是引发了妊娠高血压,而这个病因其实从中医理论来讲,是可以预防的。

    0

  10. 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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Oct 16 08:55:28 CST 2021, time=2021-10-16, status=1, ipAttribution=)]
    2021-10-16 查查佳佳

    这项全国性队列研究使用了法国国家健康

    0

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该研究的模型在预测HDP女性发生CVD的10年风险方面表现良好。研究人员建议在考虑用于临床之前增加临床变量并进行外部验证。

AJKD:妊娠高血压疾病后急性肾损伤的风险

先兆子痫是分娩后90天以上发生AKI的危险因素。该研究结果表明,将妊娠史作为急性肾病综合风险评估的一部分具有潜在意义,并表明伴有HDP病史的女性可能从肾功能监测中受益。

JAHA:妊娠高血压疾病和妊娠前高血压的女性在分娩后心衰风险

患有HDP和孕前高血压的妇女在分娩后5年内有较高的HF风险(伴有先兆子痫的患者最高)。无论是否有孕前高血压,伴有HDP的NHB女性发生HF风险高于NHW女性。

Hypertension:妊娠高血压疾病妇女的心力衰竭风险

与没有HDP的妇女相比,先兆子痫妇女,尤其是只生育一胎和复发性先兆子痫妇女,发生HF的风险增加。需要进一步研究以阐明这种因果关系的机制。

Neurology:妊娠高血压疾病与认知障碍

妊娠15年后,HDP病史与较差的工作记忆和言语学习独立相关。该关联主要由GH女性所介导。临床医生和经历过HDP的妇女应意识到这种风险。

Hypertension:多囊卵巢综合症、肥胖症以及体重增加与妊娠高血压疾病之间的关联

肥胖,特别是腹部肥胖,以及从青春期到46岁期间的体重增加,而非srPCOS或高雄激素血症,与HDP的风险增加有关。