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Oishi M, Tanaka K, Ishihara K, Iino K, Ito A, Yokoyama Y. Current status of long-term follow-up system for women with a history of hypertensive disorders of pregnancy: the HDP-PPAP study (HDP-Postpartum in Aomori prefecture study). J Matern Fetal Neonatal Med 2023; 36:2183757. [PMID: 36863711 DOI: 10.1080/14767058.2023.2183757] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
OBJECTIVE Women with a history of hypertensive disorders of pregnancy (HDP), especially those with gestational hypertension and preeclampsia, are more likely to develop hypertension, cerebrovascular disease, ischemic heart disease, diabetes mellitus, dyslipidemia, and chronic kidney disease later in life. However, the risk of lifestyle-related diseases in the immediate postpartum period among Japanese women with preexisting HDP is unclear, and a follow-up system for women with preexisting HDP has not been established in Japan. The purpose of this study was to examine the risk factors for lifestyle-related diseases in Japanese women in the immediate postpartum period and the usefulness of HDP follow-up outpatient clinics based on the situation of the HDP follow-up outpatient clinic at our hospital. METHOD We included 155 women with a history of HDP who visited our outpatient clinic between April 2014 and February 2020. We examined the reasons for dropout during the follow-up period. We also examined the number of new cases of lifestyle-related diseases and compared Body Mass Index(BMI), blood pressure values, and blood and urine test results at 1 and 3 years postpartum in 92 women who had been continuously followed for more than 3 years postpartum. RESULTS The average age of our patient cohort was 34.8 ± 4.5 years. A total of 155 women with previous HDP were continuously followed for more than 1 year, of whom 23 had new pregnancies, and eight had recurrent HDP (recurrence rate 34.8%). Of the 132 patients who were not newly pregnant, 28 dropped out during follow-up, the most common reason being that the patient did not show up. The patients in this study developed hypertension, diabetes mellitus, and dyslipidemia within a short period. Both systolic and diastolic blood pressures were at normal high levels at 1-year postpartum, and BMI significantly increased at 3 years postpartum. Blood tests revealed significant deterioration in creatinine (Cre), estimated glomerular filtration rate (eGFR), and γ-glutamyl transpeptidase (γGTP) levels. CONCLUSION In this study, women with preexisting HDP were found to have developed hypertension, diabetes, and dyslipidemia several years postpartum. We also found a significant increase in BMI and worsening of Cre, eGFR, and γGTP levels at 1 and 3 years postpartum. Although the 3-year follow-up rate at our hospital was relatively good (78.8%), some women discontinued follow-up due to self-interruption or relocation, suggesting the need to establish a nationwide follow-up system.
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Affiliation(s)
- Maika Oishi
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kanji Tanaka
- Perinatal Medical Center, Hirosaki University Hospital, Hirosaki, Japan
| | - Kana Ishihara
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kaori Iino
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Asami Ito
- Perinatal Medical Center, Hirosaki University Hospital, Hirosaki, Japan
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Pavlidou E, Papadopoulou SK, Alexatou O, Tsourouflis G, Antasouras G, Louka A, Chatziprodromidou IP, Mentzelou M, Sampani A, Chrysafi M, Apostolou T, Dakanalis A, Papadopoulou VG, Giaginis C. Association of Gestational Hypertension with Sociodemographic and Anthropometric Factors, Perinatal Outcomes, Breastfeeding Practices, and Mediterranean Diet Adherence: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2103. [PMID: 38138206 PMCID: PMC10744616 DOI: 10.3390/medicina59122103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Gestational hypertension has been associated with several pregnancy short-term and long-term complications, affecting both the mother and her infant's health. The present study aims to assess the potential association of gestational hypertension with sociodemographic and anthropometry factors, perinatal outcomes, breastfeeding habits, and Mediterranean diet (MD) compliance. Materials and Methods: This is a cross-sectional study conducted on 5271 mothers that was carried out after delivery. The anthropometry characteristics and perinatal outcomes were retrieved from the mothers' medical records. Sociodemographic characteristics, MD adherence, and breastfeeding habits were assessed via one-to-one interviews of the assigned women with qualified staff. Results: Maternal older age, being employed, family history of gestational hypertension, overweight/obesity before gestation, and abnormal gestational weight gain (GWG) independently increased the risk of developing gestational hypertension. Moreover, gestational hypertension was independently related with a greater incidence of abnormal childbirth body weight and preterm birth, not exclusively breastfeeding, and lower levels of MD adherence. Conclusions: This study highlights the importance of informing future mothers about the risk factors of gestational hypertension, underlining also that a healthy lifestyle, which simultaneously includes a healthy nutritional pattern such as MD, may decrease the risk of developing gestational hypertension and the subsequent pregnancy complications.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (V.G.P.)
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, 11527 Athens, Greece;
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Aikaterini Louka
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | | | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Anastasia Sampani
- First Department of Pathology, Medical School, University of Athens, 11527 Athens, Greece;
| | - Maria Chrysafi
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Thomas Apostolou
- Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Antonios Dakanalis
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
- Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
| | - Vasiliki G. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (V.G.P.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
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Burger RJ, Delagrange H, van Valkengoed IGM, de Groot CJM, van den Born BJH, Gordijn SJ, Ganzevoort W. Hypertensive Disorders of Pregnancy and Cardiovascular Disease Risk Across Races and Ethnicities: A Review. Front Cardiovasc Med 2022; 9:933822. [PMID: 35837605 PMCID: PMC9273843 DOI: 10.3389/fcvm.2022.933822] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 06/06/2022] [Indexed: 12/30/2022] Open
Abstract
Pregnancy is often considered to be a "cardiometabolic stress-test" and pregnancy complications including hypertensive disorders of pregnancy can be the first indicator of increased risk of future cardiovascular disease. Over the last two decades, more evidence on the association between hypertensive disorders of pregnancy and cardiovascular disease has become available. However, despite the importance of addressing existing racial and ethnic differences in the incidence of cardiovascular disease, most research on the role of hypertensive disorders of pregnancy is conducted in white majority populations. The fragmented knowledge prohibits evidence-based targeted prevention and intervention strategies in multi-ethnic populations and maintains the gap in health outcomes. In this review, we present an overview of the evidence on racial and ethnic differences in the occurrence of hypertensive disorders of pregnancy, as well as evidence on the association of hypertensive disorders of pregnancy with cardiovascular risk factors and cardiovascular disease across different non-White populations, aiming to advance equity in medicine.
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Affiliation(s)
- Renée J Burger
- Department of Obstetrics and Gynaecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands.,Amsterdam Reproduction and Development, Pregnancy and Birth, Amsterdam, Netherlands
| | - Hannelore Delagrange
- Department of Obstetrics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Irene G M van Valkengoed
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, Netherlands
| | - Christianne J M de Groot
- Amsterdam Reproduction and Development, Pregnancy and Birth, Amsterdam, Netherlands.,Department of Obstetrics and Gynaecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Bert-Jan H van den Born
- Department of Vascular Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands.,Amsterdam Cardiovascular Sciences, Atherosclerosis and Ischemic Syndromes, Amsterdam, Netherlands
| | - Sanne J Gordijn
- Department of Obstetrics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Wessel Ganzevoort
- Department of Obstetrics and Gynaecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands.,Amsterdam Reproduction and Development, Pregnancy and Birth, Amsterdam, Netherlands
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Peltokorpi A, Irina L, Liisa V, Risto K. Preconceptual leptin levels in gestational diabetes and hypertensive pregnancy. Hypertens Pregnancy 2022; 41:70-77. [PMID: 35179083 DOI: 10.1080/10641955.2022.2033763] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Pregnancy - induced hypertension (PIH), preeclampsia (PE), and gestational diabetes (GDM) are common adverse outcomes in pregnancy. OBJECTIVE To find out whether preconceptual leptin levels differ in subsequent pregnancy between control vs. GDM and hypertensive pregnancy groups. MATERIALS AND METHODS Data was from The Cardiovascular Risk in Young Finns Study and The Medical Birth Register of Finland. Of 293 subjects 71 developed GDM, 27 PIH/PE and 201 were controls. RESULTS Leptin was higher in GDM (p < 0.0001) and PIH/PE (p = 0.0002) groups compared to control. GDM group was robust to BMI matching (p = 0,0081). CONCLUSION Leptin was higher in GDM (p < 0.0001) and PIH/PE (p = 0.0002) groups compared to control. GDM group was robust to BMI matching (p = 0,0081).
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Affiliation(s)
- Antti Peltokorpi
- Department of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Lisinen Irina
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Viikari Liisa
- Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Kaaja Risto
- Department of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland
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Johnston A, Tseung V, Dancey SR, Visintini SM, Coutinho T, Edwards JD. Use of Race, Ethnicity, and National Origin in Studies Assessing Cardiovascular Risk in Women With a History of Hypertensive Disorders of Pregnancy. CJC Open 2021; 3:S102-S117. [PMID: 34993440 PMCID: PMC8712581 DOI: 10.1016/j.cjco.2021.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/10/2021] [Indexed: 11/06/2022] Open
Abstract
Women with a history of hyperBtensive disorders of pregnancy (HDP) are at particularly high risk for cardiovascular disease (CVD) and CVD-related death, and certain racial and ethnic subpopulations are disproportionately affected by these conditions. We examined the use of race, ethnicity, and national origin in observational studies assessing CVD morbidity and mortality in women with a history of HDP. A total of 124 studies, published between 1976 and 2021, were reviewed. We found that white women were heavily overrepresented, encompassing 53% of all participants with HDP. There was limited and heterogeneous reporting of race and ethnicity information across studies and only 27 studies reported including race and/or ethnicity variables in at least 1 statistical analysis. Only 2 studies mentioned the use of these variables as a strength; several others (k = 18) reported a lack of diversity among participants as a study limitation. Just over half of included articles (k = 68) reported at least 1 sociodemographic variable other than race and ethnicity (eg, marital status and income); however, none investigated how they might have worked synergistically or antagonistically with race and/or ethnicity to influence participants' risk of CVD. These findings highlight significant areas for improvement in cardiovascular obstetrics research, including the need for more robust and standardized methods for collecting, reporting, and using sociodemographic information. Future studies of CVD risk in women with a history of HDP should explicitly examine racial and ethnic differences and use an intersectional approach.
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Affiliation(s)
- Amy Johnston
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Brain and Heart Nexus Research Program, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Victrine Tseung
- Brain and Heart Nexus Research Program, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Sonia R. Dancey
- School of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sarah M. Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Thais Coutinho
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Canadian Women’s Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Jodi D. Edwards
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Brain and Heart Nexus Research Program, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- IC/ES, Ottawa, Ontario, Canada
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6
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Ri M, Hayashi K, Kurabayashi T, Lee JS, Ideno Y, Nagai K, Yasui T, Kubota T, Takamatsu K. Hypertensive disorders of pregnancy increase the risk of future menopausal hot flashes in Japanese women: results from the Japan Nurses' Health Study. Menopause 2021; 29:164-169. [PMID: 34698675 DOI: 10.1097/gme.0000000000001889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We aimed to investigate whether hypertensive disorders of pregnancy (HDP) are associated with problematic hot flashes in Japanese women. METHODS In this study, we included participants in the Japan Nurses' Health Study who were women aged 41 to 55 years at baseline, parous, and completed a 4-year follow-up questionnaire. The main outcome was self-reported problematic hot flashes. At the 4-year follow-up survey, we investigated hot flashes using the Climacteric Symptom Checklist for Japanese Women, which was developed by a subcommittee of the Japan Society of Obstetrics and Gynecology. RESULTS At the baseline survey, of the 4,627 women included in the analysis, 610 (13.2%) reported a history of HDP. At the 4-year follow-up survey, 394 women (8.5%) reported problematic hot flashes, 529 (11.4%) were diagnosed with premenopausal hypertension, and 2,389 (51.5%) were postmenopausal. Multivariable logistic regression analysis revealed a multivariable-adjusted odds ratio (95% confidence interval) of problematic hot flashes for women with a history of HDP of 1.42 (1.04-1.94), compared with women without this history. Among women without premenopausal hypertension, the odds ratio increased to 1.55 (1.10-2.19) among women with HDP as compared with those without these disorders. CONCLUSIONS In this prospective study, we found that women with a history of HDP have a significantly increased risk of problematic hot flashes, compared with their counterparts without a history of HDP.
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Affiliation(s)
- Moyo Ri
- Unit of International and Community Health Science, Graduate School of Health Sciences, Gunma University, Maebashi, Japan
- Department of Nursing, Takasaki University of Health and Welfare, Takasaki, Japan
| | - Kunihiko Hayashi
- Unit of International and Community Health Science, Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Takumi Kurabayashi
- Department of Obstetrics & Gynecology, Niigata City General Hospital, Niigata, Japan
| | - Jung Su Lee
- Postgraduate School of Healthcare, Tokyo Healthcare University, Tokyo, Japan
| | - Yuki Ideno
- Center for Mathematics and Data Science, Gunma University, Maebashi, Japan
| | - Kazue Nagai
- Research and Education Center of Health Science, School of Health Science, Gunma University, Maebashi, Japan
| | - Toshiyuki Yasui
- Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | | | - Kiyoshi Takamatsu
- Department of Obstetrics and Gynecology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
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Kurabayashi T, Mizunuma H, Kubota T, Nagai K, Hayashi K. Low Birth Weight and Prematurity Are Associated with Hypertensive Disorder of Pregnancy in Later Life: A Cross-Sectional Study in Japan. Am J Perinatol 2021; 38:1096-1102. [PMID: 32120423 DOI: 10.1055/s-0040-1705134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE We previously reported that hypertensive disorder of pregnancy (HDP) was a risk factor for hypertension and hypercholesterolemia in later life. Additionally, the age-adjusted odds ratio (OR) of HDP was 2.72 for Japanese women whose mothers had a history of HDP versus those whose mothers did not. This study aimed to clarify the association of HDP with birth weight and gestational age. STUDY DESIGN A self-administered baseline survey of the Japanese Nurses' Health Study (JNHS) cohort was conducted from 2001 to 2007. Data on 17,278 parous female nurses who knew their own birth weights were extracted from the JNHS baseline survey (n = 49,927) and subjected to cross-sectional, retrospective analysis. Data on weeks of gestation, birth weight, and history of HDP were collected. RESULTS The age-adjusted ORs for HDP were 1.62 (95% confidence interval [CI]: 1.20-2.19) for birth weight <2,000 g, 1.24 (CI: 1.04-1.48) for 2,000 to 2,499 g, 1.11 (CI: 1.00-1.23) for 2,500 to 2,999 g, and 1.08 (CI: 0.94-1.24) for ≥3,500 g compared with 3,000 to 3,499 g. The age-adjusted ORs for HDP were 1.27 (95% CI: 1.04-1.54) for a gestational age < 37 weeks and 0.93 (0.70-1.23) for ≥42 weeks compared with 37-41 weeks. The age-adjusted OR of the birth weight score for HDP in later life was 0.98 (CI: 0.94-1.03; Cochran-Armitage trend test: z = 0.401, p = 0.688). CONCLUSION Among women in Japan, a history of low birth weight and prematurity are risk factors for HDP in later life. The risk of HDP among women born with low birth weight and/or premature deserves attention.
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Affiliation(s)
- Takumi Kurabayashi
- Department of Obstetrics and Gynecology, Niigata City General Hospital, Niigata, Japan
| | - Hideki Mizunuma
- Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan
| | | | - Kazue Nagai
- Unit of Community Health Sciences, School of Health Sciences, Gunma University, Maebashi, Gunma, Japan
| | - Kunihiko Hayashi
- Unit of Community Health Sciences, School of Health Sciences, Gunma University, Maebashi, Gunma, Japan
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8
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Wu R, Wang T, Gu R, Xing D, Ye C, Chen Y, Liu X, Chen L. Hypertensive Disorders of Pregnancy and Risk of Cardiovascular Disease-Related Morbidity and Mortality: A Systematic Review and Meta-Analysis. Cardiology 2020; 145:633-647. [PMID: 32841945 DOI: 10.1159/000508036] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/15/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Several studies have demonstrated that there is a higher risk of cardiovascular disease (CVD) in women with a history of hypertensive disorders of pregnancy (HDP). However, effect sizes varied greatly between these studies, and a complete overview of the existing data in the literature is lacking. We aimed to evaluate the association between HDP and the risk of CVD-related morbidity and mortality. METHODS Systematic literature searches were conducted in several electronic databases from inception to July 2019. Exposure of interest was any type of HDP. Outcomes of interest included any CVD, CVD-related mortality, and hypertension. RESULTS Sixty-six cohort and 7 case-control studies involving >13 million women were included. The overall combined relative risks (RRs) for women with a history of HDP compared with the reference group were 1.80 (95% confidence interval [CI] 1.67-1.94) for any CVD, 1.66 (1.49-1.84) for coronary artery heart disease, 2.87 (2.14-3.85) for heart failure, 1.60 (1.29-2.00) for peripheral vascular disease, 1.72 (1.50-1.97) for stroke, 1.78 (1.58-2.00) for CVD-related mortality, and 3.16 (2.74-3.64) for hypertension. Significant heterogeneity was partially explained by all or part of the variables including type of exposure, follow-up time, geographic region, and sample source. CONCLUSIONS Women with a history of HDP are at an increased risk of future CVD-related morbidity and mortality. Our study highlights the importance of life-long monitoring of cardiovascular risk factors in women with a history of HDP.
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Affiliation(s)
- Rong Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Runhui Gu
- School of Public Health, Nanjing Medical University, Jiangsu, China
| | - Dexiu Xing
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Changxiang Ye
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Yan Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Xiaoling Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China,
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Ou M, Zhao H, Ji G, Zhao X, Zhang Q. Long noncoding RNA MALAT1 contributes to pregnancy-induced hypertension development by enhancing oxidative stress and inflammation through the regulation of the miR-150-5p/ET-1 axis. FASEB J 2020; 34:6070-6085. [PMID: 32246794 DOI: 10.1096/fj.201902280r] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/06/2020] [Accepted: 02/02/2020] [Indexed: 12/21/2022]
Abstract
Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) has been identified previously in the pathogenesis of hypertension and some gestational diseases. However, the biological functions of MALAT1 in pregnancy-induced hypertension (PIH) are still poorly understood. Herein, we aim to explore the functional relevance of MALAT1 in PIH and to explain the potential underlying mechanisms. We found that the levels of ET-1 and MALAT1 were upregulated and that of miR-150-5p were downregulated in the serum of pregnant women with PIH and the aortic endothelial cells (ECs) of reduced uterine perfusion pressure (RUPP)-induced rat models. In aortic ECs, MALAT1 could competitively bind to miR-150-5p to upregulate the expression of ET-1. The MALAT1/miR-150-5p/ET-1 axis regulated the expression of endothelin B receptor (ETBR) in aortic ECs leading to oxidative stress imbalance and increased the release of proinflammatory cytokines (IL-18 and IL-1β), which concurrently activated the NF-κB pathway to regulate the ETBR expression and to stimulate smooth muscle cell (SMC) contraction. Furthermore, silencing MALAT1 could alleviate the hypertensive symptoms of RUPP-induced rat models. Taken conjointly, the upregulation of MALAT1 can reduce the expression of ET-1 by competitively binding to miR-150-5p, which enhances the expression of ETBR via the activation of the NF-κB pathway in SMCs, thus exacerbating the hypertensive symptoms in the RUPP-induced rat models.
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Affiliation(s)
- Minghui Ou
- Department of Vascular Surgery, Qingdao Municipal Hospital, Qingdao, P.R. China
| | - Huidong Zhao
- Department of Obstetrics, Qingdao Municipal Hospital, Qingdao, P.R. China
| | - Guoxin Ji
- Department of Obstetrics, Qingdao Municipal Hospital, Qingdao, P.R. China
| | - Xin Zhao
- Department of Obstetrics, Qingdao Municipal Hospital, Qingdao, P.R. China
| | - Qian Zhang
- Department of Obstetrics, Qingdao Municipal Hospital, Qingdao, P.R. China
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Melchiorre K, Thilaganathan B, Giorgione V, Ridder A, Memmo A, Khalil A. Hypertensive Disorders of Pregnancy and Future Cardiovascular Health. Front Cardiovasc Med 2020; 7:59. [PMID: 32351977 PMCID: PMC7174679 DOI: 10.3389/fcvm.2020.00059] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/24/2020] [Indexed: 12/24/2022] Open
Abstract
Hypertensive disorders of pregnancy (HDP) occur in almost 10% of gestations. These women are known to have higher cardiovascular morbidity and mortality later in life in comparison with parous controls who had normotensive pregnancies. Several studies have demonstrated that women with preeclampsia present in a state of segmental impaired myocardial function, biventricular chamber dysfunction, adverse biventricular remodeling, and hypertrophy, a compromised hemodynamic state and indirect echocardiographic signs of localized myocardial ischemia and fibrosis. These cardiac functional and geometric changes are known to have strong predictive value for cardiovascular disease in non-pregnant subjects. A "dose effect" response seems to regulate this relationship with severe HDP, early-onset HDP, coexistence of fetal growth disorders, and recurrence of HDP resulting in poorer cardiovascular measures. The mechanism underlying the relationship between HDP in younger women and cardiovascular disease later in life is unclear but could be explained by sharing of pre-pregnancy cardiovascular risk factors or due to a direct impact of HDP on the maternal cardiovascular system conferring a state of increased susceptibility to future metabolic or hemodynamic insults. If so, the prevention of HDP itself would become all the more urgent. Shortly after delivery, women who experienced HDP express an increased risk of classic cardiovascular risk factors such as essential hypertension, renal disease, abnormal lipid profile, and diabetes with higher frequency than controls. Within one or two decades after delivery, this group of women are more likely to experience premature cardiovascular events, such as symptomatic heart failure, myocardial ischemia, and cerebral vascular disease. Although there is general agreement that women who suffered from HDP should undertake early screening for cardiovascular risk factors in order to allow for appropriate prevention, the exact timing and modality of screening has not been standardized yet. Our findings suggest that prevention should start as early as possible after delivery by making the women aware of their increased cardiovascular risk and encouraging weight control, stop smoking, healthy diet, and daily exercise which are well-established and cost-effective prevention strategies.
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Affiliation(s)
- Karen Melchiorre
- Department of Obstetrics and Gynecology, Spirito Santo Hospital of Pescara, Pescara, Italy
| | - Basky Thilaganathan
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, United Kingdom
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
| | - Veronica Giorgione
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
| | - Anna Ridder
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
| | - Alessia Memmo
- Department of Obstetrics and Gynecology, Spirito Santo Hospital of Pescara, Pescara, Italy
| | - Asma Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, United Kingdom
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
- *Correspondence: Asma Khalil
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Groenhof TKJ, van Rijn BB, Franx A, Roeters van Lennep JE, Bots ML, Lely AT. Preventing cardiovascular disease after hypertensive disorders of pregnancy: Searching for the how and when. Eur J Prev Cardiol 2017; 24:1735-1745. [PMID: 28895439 PMCID: PMC5669282 DOI: 10.1177/2047487317730472] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background Women with a history of a hypertensive disorder during pregnancy (HDP) have an increased risk of cardiovascular events. Guidelines recommend assessment of cardiovascular risk factors in these women later in life, but provide limited advice on how this follow-up should be organized. Design Systematic review and meta-regression analysis. Methods The aim of our study was to provide an overview of existing knowledge on the changes over time in three major modifiable components of cardiovascular risk assessment after HDP: blood pressure, glucose homeostasis and lipid levels. Data from 44 studies and up to 6904 women with a history of a HDP were compared with risk factor levels reported for women of corresponding age in the National Health And Nutrition Examination Survey, Estudio Epidemiólogico de la Insuficiencia Renal en España and Hong Kong cohorts (N = 27,803). Results Compared with the reference cohort, women with a HDP presented with higher mean blood pressure. Hypertension was present in a higher rate among women with a previous HDP from 15 years postpartum onwards. At 15 years postpartum (±age 45), one in five women with a history of a HDP suffer from hypertension. No differences in glucose homeostasis parameters or lipid levels were observed. Conclusions Based on our analysis, it is not possible to point out a time point to commence screening for cardiovascular risk factors in women after a HDP. We recommend redirection of future research towards the development of a stepwise approach identifying the women with the highest cardiovascular risk.
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Affiliation(s)
- T Katrien J Groenhof
- 1 Wilhelmina Children's Hospital Birth Center, University Medical Center Utrecht, The Netherlands
| | - Bas B van Rijn
- 1 Wilhelmina Children's Hospital Birth Center, University Medical Center Utrecht, The Netherlands.,2 Academic Unit of Human Development and Health, Institute for Life Sciences, University of Southampton, UK
| | - Arie Franx
- 1 Wilhelmina Children's Hospital Birth Center, University Medical Center Utrecht, The Netherlands
| | | | - Michiel L Bots
- 4 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - A Titia Lely
- 1 Wilhelmina Children's Hospital Birth Center, University Medical Center Utrecht, The Netherlands
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Association between hypertensive disorders of pregnancy and the risk of postpartum hypertension: a cohort study in women with gestational diabetes. J Hum Hypertens 2017; 31:725-730. [PMID: 28660887 PMCID: PMC5628121 DOI: 10.1038/jhh.2017.46] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 04/28/2017] [Accepted: 05/23/2017] [Indexed: 11/08/2022]
Abstract
Previous studies in general people indicated that hypertensive disorders of pregnancy (HDP) increased the risk of subsequent hypertension after delivery. Some studies found that women with gestational diabetes mellitus (GDM) had an increased risk of HDP. However, very few studies have assessed the association between HDP and the risk of postpartum hypertension among GDM women. To evaluate the association between HDP and the risk of postpartum hypertension among GDM women, a retrospective cohort study was conducted in 1261 women with prior GDM at their postpartum 1–5 years using the baseline data from Tianjin Gestational Diabetes Mellitus Prevention Program. Cox regression models were applied to assess the single and joint associations of having a history of HDP, maternal pre-pregnancy Body mass index (BMI) (normal weight, overweight and obesity), and weight change from preconception to post-delivery with the risk of subsequent hypertension among the GDM women. We found that GDM women with a history of HDP, high pre-pregnancy BMI and weight gain more than 7 kg from preconception to post-delivery had an increased risk of postpartum hypertension. Joint effects analysis revealed that the positive association between a history of HDP in the index pregnancy and the risk of postpartum hypertension was consistent in GDM women with different levels of pre-pregnancy BMI or weight gain from preconception to post-delivery. In conclusion, a history of HDP, high pre-pregnancy BMI and weight gain more than 7 kg from preconception to post-delivery increase the risk of subsequent hypertension in postpartum 1–5 years among GDM women.
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Oishi M, Iino K, Tanaka K, Ishihara K, Yokoyama Y, Takahashi I, Mizunuma H. Hypertensive disorders of pregnancy increase the risk for chronic kidney disease: A population-based retrospective study. Clin Exp Hypertens 2017; 39:361-365. [DOI: 10.1080/10641963.2016.1267197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Maika Oishi
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kaori Iino
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kanji Tanaka
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kana Ishihara
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Ippei Takahashi
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hideki Mizunuma
- Fukushima Medical Center for Children and Women, Medical University, Fukushima, Japan
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Wang Z, Wang Z, Wang L, Qiu M, Wang Y, Hou X, Guo Z, Wang B. Hypertensive disorders during pregnancy and risk of type 2 diabetes in later life: a systematic review and meta-analysis. Endocrine 2017; 55:809-821. [PMID: 27518283 DOI: 10.1007/s12020-016-1075-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 07/31/2016] [Indexed: 12/24/2022]
Abstract
Many studies assessed the association between hypertensive disorders during pregnancy and risk of type 2 diabetes mellitus in later life, but contradictory findings were reported. A systemic review and meta-analysis was carried out to elucidate type 2 diabetes mellitus risk in women with hypertensive disorders during pregnancy. Pubmed, Embase, and Web of Science were searched for cohort or case-control studies on the association between hypertensive disorders during pregnancy and subsequent type 2 diabetes mellitus. Random-effect model was used to pool risk estimates. Bayesian meta-analysis was carried out to further estimate the type 2 diabetes mellitus risk associated with hypertensive disorders during pregnancy. Seventeen cohort or prospective matched case-control studies were finally included. Those 17 studies involved 2,984,634 women and 46,732 type 2 diabetes mellitus cases. Overall, hypertensive disorders during pregnancy were significantly correlated with type 2 diabetes mellitus risk (relative risk = 1.56, 95 % confidence interval 1.21-2.01, P = 0.001). Preeclampsia was significantly and independently correlated with type 2 diabetes mellitus risk (relative risk = 2.25, 95 % confidence interval 1.73-2.90, P < 0.001). In addition, gestational hypertension was also significantly and independently correlated with subsequent type 2 diabetes mellitus risk (relative risk = 2.06, 95 % confidence interval 1.57-2.69, P < 0.001). The pooled estimates were not significantly altered in the subgroup analyses of studies on preeclampsia or gestational hypertension. Bayesian meta-analysis showed the relative risks of type 2 diabetes mellitus risk for individuals with hypertensive disorders during pregnancy, preeclampsia, and gestational hypertension were 1.59 (95 % credibility interval: 1.11-2.32), 2.27 (95 % credibility interval: 1.67-2.97), and 2.06 (95 % credibility interval: 1.41-2.84), respectively. Publication bias was not evident in the meta-analysis. Preeclampsia and gestational hypertension are independently associated with substantially elevated risk of type 2 diabetes mellitus in later life.
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Affiliation(s)
- Zengfang Wang
- Department of Obstetrics, Maternal and Children Health's Hospital of Weifang, Weifang, 261011, China.
| | - Zengyan Wang
- Surgical Center, Zhucheng People's Hospital, Zhucheng, 262201, China
| | - Luang Wang
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Mingyue Qiu
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Yangang Wang
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Xu Hou
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Zhong Guo
- Department of Medical Education, Health School of Ganzhou in Jiangxi Province, Ganzhou, 341000, China
| | - Bin Wang
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
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Oishi M, Tanaka K, Ishihara K, Iino K, Yokoyama Y, Mizunuma H. Results of a questionnaire survey on blood pressure management in hypertensive disorders of pregnancy in Aomori prefecture, Japan. HYPERTENSION RESEARCH IN PREGNANCY 2017. [DOI: 10.14390/jsshp.hrp2017-006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Maika Oishi
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine
| | - Kanji Tanaka
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine
| | - Kana Ishihara
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine
| | - Kaori Iino
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine
| | - Hideki Mizunuma
- Fukushima Medical Center for Children and Women, Fukushima Medical University
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Im MJ, Cho DS. Salt Preference and Sodium Intake among Pregnant Women. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2016; 22:297-307. [PMID: 37684878 DOI: 10.4069/kjwhn.2016.22.4.297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 12/03/2016] [Accepted: 12/14/2016] [Indexed: 09/10/2023] Open
Abstract
PURPOSE This study was to estimate salt preference and sodium intake of pregnant women, and identify the relationship between salt preference and sodium intake. METHODS Research design was a cross sectional correlational survey with 197 pregnant women who visited outpatient clinics for antenatal care. The sodium intake levels were estimated by the amounts of sodium intake using the 24-hour recall method and sodium concentration in spot urine. The data were analyzed using descriptive statistics, t-test, ANOVA and Pearson's correlation. RESULTS Sodium intake using 24-hour recall method was 3,504±1,359 mg. Sodium intake levels had statistically significant differences depending on income. The average amount of sodium in spot urine was 2,882±878mg/day. Sodium excretion levels had statistically significant differences depending on whether participants had preexisting hypertension in their family history and Body Mass Index (BMI) pre-conception. Salt preference was 62.61±20.96 out of 180 points. Salt preference had significant differences depending on income, parity, gestational age, BMI pre-conception and showed negative correlation with sodium quantity in spot urine. CONCLUSION Sodium intake in pregnant women recommended by World Health Organization recommended is 175%. Salt preference was not significantly different between sodium intake levels, however it was negatively correlated with sodium quantity in spot urine among pregnant women.
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Affiliation(s)
- Mi Jeung Im
- Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Dong Sook Cho
- Nowon Eulji Medical Center, Eulji University, Seoul, Korea
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Tomimatsu T, Mimura K, Endo M, Kumasawa K, Kimura T. Pathophysiology of preeclampsia: an angiogenic imbalance and long-lasting systemic vascular dysfunction. Hypertens Res 2016; 40:305-310. [PMID: 27829661 DOI: 10.1038/hr.2016.152] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 10/07/2016] [Accepted: 10/07/2016] [Indexed: 01/13/2023]
Abstract
Preeclampsia is a systemic vascular disorder characterized by new-onset hypertension and proteinuria after 20 weeks of gestation. This condition targets several organs, including the kidneys, liver and brain, and is the leading cause of maternal and perinatal morbidity and mortality. Furthermore, recent evidence has revealed preeclampsia as a significant risk factor for future cardiovascular diseases in these women. Over the past decade, increasing evidence has indicated that maternal angiogenic imbalances caused by placental antiangiogenic factors play a central role in the systemic vascular dysfunction underling preeclampsia. The severity of the maternal antiangiogenic state correlates closely with maternal and perinatal outcomes. Assessing angiogenic imbalance and several vascular function tests have also emerged as a way of detecting systemic vascular dysfunction during pregnancy. This review summarizes the current understanding of the pathophysiology of preeclampsia, its clinical applications and clinical evidence for future cardiovascular risks.
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Affiliation(s)
- Takuji Tomimatsu
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuya Mimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masayuki Endo
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Keiichi Kumasawa
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
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Yuan X, Liu H, Wang L, Zhang S, Zhang C, Leng J, Dong L, Lv L, Lv F, Tian H, Qi L, Tuomilehto J, Hu G. Gestational hypertension and chronic hypertension on the risk of diabetes among gestational diabetes women. J Diabetes Complications 2016; 30:1269-74. [PMID: 27185731 PMCID: PMC5512696 DOI: 10.1016/j.jdiacomp.2016.04.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 04/15/2016] [Accepted: 04/30/2016] [Indexed: 01/03/2023]
Abstract
AIMS We aimed to examine the association of gestational hypertension and chronic hypertension at the inter-conception examination with type 2 diabetes risk among women with a history of gestational diabetes. METHODS We conducted a population-based study among 1261 women who had a history of gestational diabetes at 1-5years after delivery in Tianjin, China. Logistic regression or Cox regression was used to assess the associations of gestational hypertension and chronic hypertension at the inter-conception examination with pre-diabetes and type 2 diabetes risks. RESULTS Gestational diabetic women who had a history of gestational hypertension but did not use antihypertensive drugs during pregnancy had a 3.94-fold higher risk (95% CI: 1.94-8.02) of developing type 2 diabetes compared with those who were normotensive in index pregnancy. Compared with gestational diabetic women who had normal blood pressure at the inter-conception examination, hypertensive women at the inter-conception examination were 3.38 times (95% CI: 1.66-6.87) and 2.97 times (95% CI: 1.75-5.05) more likely to develop diabetes and prediabetes, respectively. The odds ratios of type 2 diabetes and prediabetes associated with each 5mmHg increase in systolic blood pressure were 1.25 (95% CI: 1.03-1.51) and 1.20 (95% CI: 1.06-1.35). Each 5mmHg increase in diastolic blood pressure contributed to a 1.49-fold higher risk (95% CI: 1.18-1.88) for type 2 diabetes and a 1.42-fold higher risk (95% CI: 1.22-1.65) for prediabetes. CONCLUSIONS For women with prior gestational diabetes, gestational hypertension and chronic hypertension at the inter-conception examination were risk factors for type 2 diabetes.
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Affiliation(s)
- Xiaojing Yuan
- Pennington Biomedical Research Center, Baton Rouge, LA
| | - Huikun Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Leishen Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Shuang Zhang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Cuiping Zhang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Junhong Leng
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Ling Dong
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Li Lv
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Fengjun Lv
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Huiguang Tian
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Lu Qi
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - Jaakko Tuomilehto
- Department of Public Health, University of Helsinki, Helsinki, Finland; Centre for Vascular Prevention, Danube-University Krems, Krems, Austria; Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia; Dasman Diabetes Institute, Dasman, Kuwait
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, LA.
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Iino K, Higuchi T, Ogawa M, Yamauchi Y, Misaki N, Tanaka K, Takahashi I, Mizunuma H. Blood pressure during pregnancy is a useful predictive maker for hypertension and dyslipidemia later in life, a population-based, cross-sectional study. Maturitas 2016; 87:84-8. [DOI: 10.1016/j.maturitas.2016.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 02/15/2016] [Accepted: 02/21/2016] [Indexed: 11/30/2022]
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Pregnancy-induced hypertension is associated with an increase in the prevalence of cardiovascular disease risk factors in Japanese women. Menopause 2016; 22:656-9. [PMID: 25387344 DOI: 10.1097/gme.0000000000000361] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This study assessed whether pregnancy-induced hypertension (PIH) affects the prevalence of cardiovascular disease (CVD) risk factors in later life among Japanese women. METHODS Study participants were 1,185 women (mean [SD] age, 46.5 [5.6] y; range, 38-73 y) aged 40 years or older who underwent a health checkup at a periodic health examination facility between January 2012 and December 2013 and had experienced giving birth. Questionnaires were sent to potential participants, and they were encouraged to provide their Maternal and Child Health Handbook (handbook). We recruited 101 women with a history of PIH (PIH group) and 1,084 women with uncomplicated pregnancy at delivery (control group). Groupings were based on information from the handbook. We assessed the association between PIH and CVD in later life among Japanese women by focusing on hypertension, diabetes mellitus, and dyslipidemia as risk factors for CVD. Odds ratios (ORs) for the use of antihypertensive, diabetes mellitus, and dyslipidemic medications in the PIH group were determined. RESULTS Women with PIH had increased risk of antihypertensive medication use compared with women without PIH (2.9% vs 13.9%; OR, 4.28; 95% CI, 2.14-8.57). Triglycerides were significantly higher and high-density lipoprotein cholesterol was significantly lower in the PIH group than in the control group. The OR for dyslipidemic medication use in the PIH group relative to the control group was 3.20 (95% CI, 1.42-7.22). CONCLUSIONS Our findings suggest that a history of PIH may be associated with an increased risk of hypertension (a risk factor for CVD) in later life among Japanese women.
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Kurabayashi T, Mizunuma H, Kubota T, Hayashi K. Ovarian infertility is associated with cardiovascular disease risk factors in later life: A Japanese cross-sectional study. Maturitas 2015; 83:33-9. [PMID: 26417693 DOI: 10.1016/j.maturitas.2015.08.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 08/01/2015] [Accepted: 08/28/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study aimed to clarify the association between ovarian infertility and cardiovascular disease risk factors in later life in Japanese women. STUDY DESIGN The Japan Nurses' Health Study (JNHS) is a cohort study of Japanese women's health. Data from the JNHS baseline survey (n = 49,927) between 2001 and 2007 were used in a cross-sectional, retrospective analysis. A total of 44,601 women were classified into three categories: ovarian infertility group (n=1167), other infertility group (n = 4619), and no infertility group (n = 38,815). Logistic regression analysis compared with the no infertility group was performed. MAIN OUTCOME MEASURES Age-adjusted odds ratios (ORs) and multivariable-adjusted ORs for hypertension, hypercholesterolemia, and diabetes mellitus (DM). RESULTS The prevalence of obese women (BMI ≥ 25) who were < 45 years old in the ovarian infertility group was significantly higher compared with that in the other groups. Women in the ovarian infertility group were at risk for hypertension at ≥ 45 years old (age-adjusted OR: 1.65%, confidence interval [CI]: 1.23-2.21); for hypercholesterolemia at < 45 and ≥ 45 years old (age-adjusted OR: 1.42, 95% CI: 1.06-1.88 at < 45 years; age-adjusted OR: 1.39, 95% CI: 1.06-1.81 at ≥ 45 years); and for DM at < 45 years old (age-adjusted OR: 2.92, 95% CI: 1.57-5.46). CONCLUSIONS Japanese women with ovarian infertility (most women have polycystic ovary syndrome) are at high risk of hypertension from 45 years of age, hypercholesterolemia at all ages, and diabetes mellitus (DM) before 45 years old.
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Affiliation(s)
- Takumi Kurabayashi
- Department of Obstetrics and Gynecology, Niigata City General Hospital, Niigata 950-1197, Japan.
| | - Hideki Mizunuma
- Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Hirosaki, Aomori 036-8562, Japan.
| | - Toshiro Kubota
- Department of Comprehensive Reproductive Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan.
| | - Kunihiko Hayashi
- Unit of Community Health Sciences, School of Health Sciences, Gunma University, Maebashi, Gunma 371-8511, Japan.
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Cardiovascular disease in women: the significance of hypertension and gestational diabetes during pregnancy. Curr Opin Cardiol 2015; 29:447-53. [PMID: 25003394 DOI: 10.1097/hco.0000000000000094] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Cardiovascular disease (CVD) remains the major killer of women around the globe. Complications during pregnancy, including hypertensive disorders of pregnancy and gestational diabetes mellitus, are now recognized as risk factors for future CVD. RECENT FINDINGS Studies of diverse populations demonstrate the links between these complications of pregnancy and a woman's future risk of CVD including atherosclerosis, hypertension, stroke, coronary artery disease, and heart failure. Markers that persist in these women following pregnancy continue to be identified and include microalbuminuria, proteinuria, elevated homocysteine levels, C-reactive protein, and salt sensitivity. Efforts are now being placed on establishing specialized clinics to monitor women beyond pregnancy to help reduce the burden of future disease. SUMMARY Pregnancy offers a unique window through which women at risk of future CVD may be identified. Clinicians have an opportunity to implement health monitoring, lifestyle modifications, and other interventions during this period, and beyond, that will help reduce the burden of CVD. Research should continue to focus on identifying and understanding the mechanisms that lead to future CVD in these women; deciphering whether pregnancy unmasks an existing predisposition to disease, compounds the risk of future disease, or is the direct cause of future disease.
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Rayman MP, Bath SC, Westaway J, Williams P, Mao J, Vanderlelie JJ, Perkins AV, Redman CWG. Selenium status in U.K. pregnant women and its relationship with hypertensive conditions of pregnancy. Br J Nutr 2015; 113:249-58. [PMID: 25571960 PMCID: PMC4302388 DOI: 10.1017/s000711451400364x] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 10/13/2014] [Accepted: 10/17/2014] [Indexed: 02/06/2023]
Abstract
Dietary intake/status of the trace mineral Se may affect the risk of developing hypertensive conditions of pregnancy, i.e. pre-eclampsia and pregnancy-induced hypertension (PE/PIH). In the present study, we evaluated Se status in U.K. pregnant women to establish whether pre-pregnant Se status or Se supplementation affected the risk of developing PE/PIH. The samples originated from the SPRINT (Selenium in PRegnancy INTervention) study that randomised 230 U.K. primiparous women to treatment with Se (60 μg/d) or placebo from 12 weeks of gestation. Whole-blood Se concentration was measured at 12 and 35 weeks, toenail Se concentration at 16 weeks, plasma selenoprotein P (SEPP1) concentration at 35 weeks and plasma glutathione peroxidase (GPx3) activity at 12, 20 and 35 weeks. Demographic data were collected at baseline. Participants completed a FFQ. U.K. pregnant women had whole-blood Se concentration lower than the mid-range of other populations, toenail Se concentration considerably lower than U.S. women, GPx3 activity considerably lower than U.S. and Australian pregnant women, and low baseline SEPP1 concentration (median 3.00, range 0.90-5.80 mg/l). Maternal age, education and social class were positively associated with Se status. After adjustment, whole-blood Se concentration was higher in women consuming Brazil nuts (P= 0.040) and in those consuming more than two seafood portions per week (P= 0.054). A stepwise logistic regression model revealed that among the Se-related risk factors, only toenail Se (OR 0.38, 95% CI 0.17, 0.87, P= 0.021) significantly affected the OR for PE/PIH. On excluding non-compliers with Se treatment, Se supplementation also significantly reduced the OR for PE/PIH (OR 0.30, 95% CI 0.09, 1.00, P= 0.049). In conclusion, U.K. women have low Se status that increases their risk of developing PE/PIH. Therefore, U.K. women of childbearing age need to improve their Se status.
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Affiliation(s)
- Margaret P. Rayman
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, School of Biosciences and Medicine, University of Surrey, GuildfordGU2 7XH, UK
| | - Sarah C. Bath
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, School of Biosciences and Medicine, University of Surrey, GuildfordGU2 7XH, UK
| | - Jacob Westaway
- School of Medical Science, Griffith Health Institute, Griffith University, Queensland, QLD4222, Australia
| | - Peter Williams
- Department of Mathematics, Faculty of Engineering and Physical Sciences, University of Surrey, GuildfordGU2 7XH, UK
| | - Jinyuan Mao
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, School of Biosciences and Medicine, University of Surrey, GuildfordGU2 7XH, UK
| | - Jessica J. Vanderlelie
- School of Medical Science, Griffith Health Institute, Griffith University, Queensland, QLD4222, Australia
| | - Anthony V. Perkins
- School of Medical Science, Griffith Health Institute, Griffith University, Queensland, QLD4222, Australia
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Yeh JS, Cheng HM, Hsu PF, Sung SH, Liu WL, Fang HL, Chuang SY. Synergistic effect of gestational hypertension and postpartum incident hypertension on cardiovascular health: a nationwide population study. J Am Heart Assoc 2014; 3:e001008. [PMID: 25389282 PMCID: PMC4338688 DOI: 10.1161/jaha.114.001008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Gestational hypertension (GH) is a common complication of pregnancy and is associated with increased risk of incident hypertension in later life (IH) and cardiovascular events. However, the interactive effect of GH and IH on postpartum cardiovascular health remains unclear. METHODS AND RESULTS A nationwide population-based study was conducted using 1 million individuals from the Taiwan National Health Insurance database. Records from 1998 to 2009 were used to identify 1260 pregnant women with GH and without previous cardiovascular disease. The control group comprised 5040 pregnant women without GH, matched for age and date of delivery. During the follow-up period (median duration, 5.8 years), 182 cardiovascular events developed. Women with GH had significantly higher risk of cardiovascular events (hazard ratio [95% CI], 2.44 [1.80 to 3.31]) and IH (8.29 [6.30 to 10.91]) than controls. Compared with women without GH and IH, there was a significantly higher risk of cardiovascular events for women without GH but with IH (relative risk [95% CI], 2.89 [1.27-6.58]), women with GH but without IH (1.66 [1.16-2.39]), and women with GH and IH (8.11 [5.36-12.30]). The synergy index was 2.91 (95% CI 1.11 to 7.59), suggesting a positive interaction between GH and IH. CONCLUSIONS GH increased the risk of subsequent IH. Women with both GH and IH were at a substantially higher cardiovascular risk than were women with either GH or IH. The synergistic adverse effect of GH and IH on postpartum cardiovascular health indicates that more attention should be paid to this special population.
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Affiliation(s)
- Jong Shiuan Yeh
- Cardiology Division, Internal Medicine Department, Taipei Medical University Wan-Fang Hospital, Taipei, Taiwan (J.S.Y.) Department of Medicine, Taipei Medical University, Taipei, Taiwan (J.S.Y.)
| | - Hao-Min Cheng
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (H.M.C., S.H.S.) Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan (H.M.C.) Department of Medicine, National Yang-Ming University, Taipei, Taiwan (H.M.C., P.F.H., S.H.S.)
| | - Pai-Feng Hsu
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan (P.F.H.) Department of Medicine, National Yang-Ming University, Taipei, Taiwan (H.M.C., P.F.H., S.H.S.)
| | - Shih-Hsien Sung
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (H.M.C., S.H.S.) Department of Medicine, National Yang-Ming University, Taipei, Taiwan (H.M.C., P.F.H., S.H.S.)
| | - Wen-Ling Liu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan (W.L.L., H.L.F., S.Y.C.)
| | - Hsin-Ling Fang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan (W.L.L., H.L.F., S.Y.C.)
| | - Shao-Yuan Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan (W.L.L., H.L.F., S.Y.C.)
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