scholarly journals 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 ◽  
Author(s):  
Amy Johnston ◽  
Victrine Tseung ◽  
Sonia R. Dancey ◽  
Sarah M. Visintini ◽  
Thais Coutinho ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
National Origin ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
History Of ◽  
Race Ethnicity

scholarly journals Long-Term Cardiovascular Disease Risk in Women After Hypertensive Disorders of Pregnancy: Recent Advances in Hypertension

Hypertension ◽  
2021 ◽  
Author(s):  
Kavia Khosla ◽  
Sarah Heimberger ◽  
Kristin M. Nieman ◽  
Avery Tung ◽  
Sajid Shahul ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Risk Reduction ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Hypertensive Disorders Of Pregnancy ◽  
Cardiovascular Risk Reduction ◽  
Hypertensive Disorders ◽  
History Of

Patients with a history of hypertensive disorders of pregnancy (HDP) suffer higher rates of long-term cardiovascular events including heart failure, coronary artery disease, and stroke. Cardiovascular changes during pregnancy can act as a natural stress test, subsequently unmasking latent cardiovascular disease in the form of HDP. Because HDP now affect 10% of pregnancies in the United States, the American Heart Association has called for physicians who provide peripartum care to promote early identification and cardiovascular risk reduction. In this review, we discuss the epidemiology, pathophysiology, and outcomes of HDP-associated cardiovascular disease. In addition, we propose a multi-pronged approach to support cardiovascular risk reduction for women with a history of HDP. Additional research is warranted to define appropriate blood pressure targets in the postpartum period, optimize the use of pregnancy history in risk stratification tools, and clarify the effectiveness of preventive interventions. The highest rates of HDP are in populations with poor access to resources and quality health care, making it a major risk for inequity of care. Interventions to decrease long-term cardiovascular disease risk in women following HDP must also target disparity reduction.

scholarly journals Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study

BMJ ◽  
2017 ◽  
pp. j3078 ◽  
Author(s):  
Ida Behrens ◽  
Saima Basit ◽  
Mads Melbye ◽  
Jacob A Lykke ◽  
Jan Wohlfahrt ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hypertensive Disorders Of Pregnancy ◽  
Pregnancy Hypertension ◽  
Hypertensive Disorders ◽  
History Of

Cardiovascular risk model performance in women with and without hypertensive disorders of pregnancy

Heart ◽  
2018 ◽  
Vol 105 (4) ◽  
pp. 330-336 ◽  
Author(s):  
Veerle Dam ◽  
N Charlotte Onland-Moret ◽  
W M Monique Verschuren ◽  
Jolanda M A Boer ◽  
Laura Benschop ◽  
...  
Keyword(s):  
Risk Model ◽  
Model Performance ◽  
Predictive Performance ◽  
Baseline Risk ◽  
Hypertensive Disorders Of Pregnancy ◽  
Cvd Risk ◽  
Hypertensive Disorders ◽  
Framingham Risk ◽  
History Of ◽  
Score Model

ObjectivesCompare the predictive performance of Framingham Risk Score (FRS), Pooled Cohort Equations (PCEs) and Systematic COronary Risk Evaluation (SCORE) model between women with and without a history of hypertensive disorders of pregnancy (hHDP) and determine the effects of recalibration and refitting on predictive performance.MethodsWe included 29 751 women, 6302 with hHDP and 17 369 without. We assessed whether models accurately predicted observed 10-year cardiovascular disease (CVD) risk (calibration) and whether they accurately distinguished between women developing CVD during follow-up and not (discrimination), separately for women with and without hHDP. We also recalibrated (updating intercept and slope) and refitted (recalculating coefficients) the models.ResultsOriginal FRS and PCEs overpredicted 10-year CVD risks, with expected:observed (E:O) ratios ranging from 1.51 (for FRS in women with hHDP) to 2.29 (for PCEs in women without hHDP), while E:O ratios were close to 1 for SCORE. Overprediction attenuated slightly after recalibration for FRS and PCEs in both hHDP groups. Discrimination was reasonable for all models, with C-statistics ranging from 0.70-0.81 (women with hHDP) and 0.72–0.74 (women without hHDP). C-statistics improved slightly after refitting 0.71–0.83 (with hHDP) and 0.73–0.80 (without hHDP). The E:O ratio of the original PCE model was statistically significantly better in women with hHDP compared with women without hHDP.ConclusionsSCORE performed best in terms of both calibration and discrimination, while FRS and PCEs overpredicted risk in women with and without hHDP, but improved after recalibrating and refitting the models. No separate model for women with hHDP seems necessary, despite their higher baseline risk.

scholarly journals Annual body mass index gain and risk of hypertensive disorders of pregnancy in a subsequent pregnancy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sho Tano ◽  
Tomomi Kotani ◽  
Takafumi Ushida ◽  
Masato Yoshihara ◽  
Kenji Imai ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Body Mass ◽  
Body Weight Gain ◽  
Subsequent Pregnancy ◽  
The Body ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Age Related ◽  
History Of

AbstractWeight gain during interpregnancy period is related to hypertensive disorders of pregnancy (HDP). However, in interpregnancy care/counseling, the unpredictability of the timing of the next conception and the difficulties in preventing age-related body weight gain must be considered while setting weight management goals. Therefore, we suggest considering the annual change in the body mass index (BMI). This study aimed to clarify the association between annual BMI changes during the interpregnancy period and HDP risk in subsequent pregnancies. A multicenter retrospective study of data from 2009 to 2019 examined the adjusted odds ratio (aOR) of HDP in subsequent pregnancies. The aORs in several annual BMI change categories were also calculated in the subgroups classified by HDP occurrence in the index pregnancy. This study included 1,746 pregnant women. A history of HDP (aOR, 16.76; 95% confidence interval [CI], 9.62 − 29.22), and annual BMI gain (aOR, 2.30; 95% CI, 1.76 − 3.01) were independent risk factors for HDP in subsequent pregnancies. An annual BMI increase of ≥ 1.0 kg/m2/year was related to HDP development in subsequent pregnancies for women without a history of HDP. This study provides data as a basis for interpregnancy care/counseling, but further research is necessary to validate our findings and confirm this relationship.

scholarly journals Left ventricular mass and myocardial scarring in women with hypertensive disorders of pregnancy

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001273
Author(s):  
Odayme Quesada ◽  
Ki Park ◽  
Janet Wei ◽  
Eileen Handberg ◽  
Chrisandra Shufelt ◽  
...  
Keyword(s):  
Vascular Dysfunction ◽  
Obstructive Coronary Artery Disease ◽  
Left Ventricular ◽  
Hypertensive Disorders Of Pregnancy ◽  
Similar Frequency ◽  
Hypertensive Disorders ◽  
Lv Mass ◽  
Scar Size ◽  
History Of ◽  
And Function

AimsHypertensive disorders of pregnancy (HDP) predict future cardiovascular events. We aim to investigate relations between HDP history and subsequent hypertension (HTN), myocardial structure and function, and late gadolinium enhancement (LGE) scar.Methods and resultsWe evaluated a prospective cohort of women with suspected ischaemia with no obstructive coronary artery disease (INOCA) who underwent stress/rest cardiac magnetic resonance imaging (cMRI) with LGE in the Women’s Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction study. Self-reported history of pregnancy and HDP (gestational HTN, pre-eclampsia, toxaemia and eclampsia) were collected at enrollment. In our cohort of 346, 20% of women report a history of HDP. HDP history was associated with 3.2-fold increased odds of HTN. Women with a history of both HDP and HTN had higher cMRI measured left ventricular (LV) mass compared with women with HDP only (99.4±2.6 g vs 87.7±3.2 g, p=0.02). While we found a similar frequency of LGE scar, we observed a trend towards increased LGE scar size (5.1±3.4 g vs 8.0±3.4 g, p=0.09) among the women with HDP history compared to women without.ConclusionIn a high-risk cohort of women with suspected INOCA, 20% had a history of HDP. Women with HDP history were more likely to develop HTN. Our study demonstrates higher LV mass in women with HDP and concomitant HTN. Although the presence of LGE scar was not different in women with and without HDP history, we observed a trend towards larger scar size in women with HDP. Future studies are needed to better assess the relationship of HDP and cardiac morphology and LGE scarring in a larger cohort of women.

scholarly journals Cardiovascular risk after hypertensive disorders of pregnancy in women with and without inheritable Thrombophilia

2020 ◽  
Vol 39 (2) ◽  
pp. 203-210
Author(s):  
N. N. Schonewille ◽  
C. N. H. Abheiden ◽  
A. Bokslag ◽  
A. Thijs ◽  
C. J. M. De Groot ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders
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