Document Detail


Hypertensive disorders in pregnancy and subsequently measured cardiovascular risk factors.
MedLine Citation:
PMID:  20168095     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study the association of hypertensive pregnancy disorders with modifiable risk factors for cardiovascular and metabolic diseases and to estimate the feasibility for early detection and prevention. METHODS: This was a prospective study of 15,065 women with a first singleton birth between 1967 and 1995, who later participated in a population study that included standardized measurements of blood pressure, serum lipids, and body mass index (BMI). RESULTS: Women with a history of hypertensive disorders in pregnancy (preeclampsia or gestational hypertension) had higher BMI, higher blood pressure, and unfavorable levels of total cholesterol, low-density lipoprotein cholesterol, and triglycerides. Preeclampsia was associated with substantially higher risk of developing diabetes (odds ratio 3.8, 95% confidence interval [CI] 2.1-6.6), and if the hypertensive disorder occurred in more than one pregnancy, or in a relatively late pregnancy, the associations with later cardiovascular risk factors were substantially stronger. Thus, women with two episodes of preeclampsia were approximately 10 times more likely to use blood pressure medication at follow-up (adjusted odds ratio, 11.6, 95% CI 7.1-26.3), and in women with gestational hypertension in three consecutive pregnancies, systolic pressure was on average 27 mm Hg (95% CI 18-37 mm Hg) higher, and diastolic pressure was 12 mm Hg (95% CI 5-19 mm Hg) higher, compared with women without a history of hypertensive disorders. Adjustment for current body mass index partly attenuated these associations, suggesting that BMI may play an important mediating role. CONCLUSION: Women with a history of hypertensive disorders in pregnancy, and particularly women with recurrent pregnancy disorders, should be candidates for intervention intended to prevent premature cardiovascular disease. LEVEL OF EVIDENCE: II.
Authors:
Elisabeth B Magnussen; Lars J Vatten; George Davey Smith; P?l R Romundstad
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  114     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2010-02-19     Completed Date:  2010-03-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  961-70     Citation Subset:  AIM; IM    
Affiliation:
Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure
Body Mass Index
Cardiovascular Diseases / epidemiology*,  prevention & control
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Diabetes Mellitus / epidemiology
Female
Glucose Intolerance / epidemiology
Humans
Hyperlipidemias / epidemiology
Hypertension, Pregnancy-Induced / epidemiology*
Lipids / blood
Middle Aged
Norway / epidemiology
Pre-Eclampsia / epidemiology
Pregnancy
Prospective Studies
Recurrence
Registries
Risk Factors
Triglycerides / blood
Chemical
Reg. No./Substance:
0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Lipids; 0/Triglycerides
Comments/Corrections
Comment In:
Obstet Gynecol. 2009 Nov;114(5):958-60   [PMID:  20168094 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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