高血压, pregnancy complications may greatly raise moms' future heart risks

Women who have high blood pressure before they become pregnant may be twice as likely as those who don't to develop cardiovascular disease within a decade of giving birth, 新研究发现.

如果他们的怀孕有并发症, 他们患过早心血管疾病的可能性要高出10倍, 根据这项研究, 周五发表在美国心脏协会杂志上 高血压.

The findings highlight the importance of blood pressure screenings for women of childbearing age and add to evidence suggesting pregnancy may unmask or accelerate underlying heart problems, 该研究的合著者费格斯·麦卡锡说, a perinatal researcher and senior lecturer in the department of obstetrics and gynecology at University College Cork in Ireland.

"Pregnancy can act as a natural stress test unmasking latent cardiovascular disease in the form of pregnancy complications,他说. But it is unclear whether those complications "are a marker for more severe chronic hypertension, or whether other mechanisms and attributes contribute to the elevated long-term cardiovascular disease risk associated with them."

据估计，美国9%的育龄妇女患有糖尿病.S. 是否有高血压(又称高血压) 疾病控制和预防中心. Among those who do, almost 41% are not managing it and nearly 17% don't even know they have it. Previous studies have shown maternal high blood pressure increases the risk of life-threatening problems for mother and baby.

在新的研究中, researchers analyzed the link between chronic hypertension and adverse pregnancy outcomes on later cardiovascular events, 包括中风, 心脏病, 稳定性和不稳定性心绞痛, 心脏病, 外周动脉疾病, 腹主动脉瘤, 心力衰竭和心房颤动.

不良妊娠结局包括先兆子痫, 妊娠期高血压, 早产, 死胎和胎儿生长受限. Women who were diagnosed with high blood pressure prior to pregnancy or before 20 weeks of gestation or who were taking blood pressure-lowering medications were considered to have chronic hypertension.

这项研究包括.1997年至2016年期间生育的200万49岁以下妇女. Those who had cardiovascular disease or diabetes prior to becoming pregnant were excluded. 对这些女性的跟踪调查中位数为9.3年.

整体, women who had high blood pressure prior to becoming pregnant faced double the risk for later cardiovascular problems, 与没有高血压的女性相比. Women who had high blood pressure and complicated pregnancies experienced the highest risk.

与无妊娠并发症的无慢性高血压妇女相比, 同时存在这两种问题的女性面临9分.患心力衰竭的可能性是正常人的6倍.中风的可能性要高出4倍.8 times more likely to develop atherosclerosis, or a buildup of plaque in the arteries. Even compared to women who had chronic high blood pressure but no pregnancy complications, 同时患有这两种疾病的女性患冠心病的风险增加了一倍.

Women who had pregnancy complications but did not have high blood pressure prior to becoming pregnant faced an overall 50% higher risk for future cardiovascular problems, 与没有慢性高血压或妊娠并发症的人相比.

"It's possible that women who have an adverse pregnancy outcome activate several different biologic pathways that might not turn off after pregnancy,”医生说。. 帕瑞克豪尼莎, 加州大学临床医学副教授, 旧金山. “就像你心脏病发作一样，之后你的生理机能就不一样了."

The findings highlight the importance of screening women who are considering becoming pregnant so blood pressure can be managed before they do, 帕瑞克豪表示, 谁没有参与这项研究. "Often women don't even know they have high blood pressure until they get pregnant and have it measured during prenatal visits,她说.

同样的, steps should be taken to prevent pregnancy complications in women with a history of high blood pressure, 她说. 一种方法是在怀孕早期给她们小剂量的阿司匹林, which has been shown to help prevent a complication called preeclampsia in women at high risk. The condition is characterized by severe high blood pressure after the 20th week of pregnancy and protein in the urine.

Having a history of pregnancy complications should prompt a more urgent approach to preventing cardiovascular disease and its risk factors through strategies such as adopting a heart-healthy diet and increasing physical activity, 根据… 2021 AHA科学声明 关于不良妊娠结局和心血管疾病风险.

因为女性经常推迟怀孕，直到她们的生育年龄, chronic hypertension – which becomes more prevalent as women get older – is a growing problem among new mothers, 帕瑞克豪表示. "It's not surprising if women give birth at older ages that they would have a higher prevalence of hypertension. 检测和筛查这一点非常重要."