Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women—2011 Update

Mosca, Lori; Benjamin, Emelia J.; Berra, Kathy; Bezanson, Judy L.; Dolor, Rowena J; Lloyd‐Jones, Donald M.; Newby, L. Kristin; Piña, Ileana L.; Roger, Véronique L.; Shaw, Leslee J.; Zhao, Dong; Beckie, Theresa M.; Bushnell, Cheryl; DʼArmiento, Jeanine; Kris-Etherton, Penny M.; Fang, Jing; Ganiats, Théodore G.; Gomes, Antoinette S.; Gracia, Clarisa R.; Haan, Constance K.; Jackson, Elizabeth A.; Judelson, Debra R.; Kelepouris, Ellie; Lavie, Carl J.; Moore, Anne; Nussmeier, Nancy A.; Ofili, Elizabeth; Oparil, Suzanne; Ouyang, Pamela; Pinn, Vivian W.; Sherif, Katherine; Smith, Sidney C.; Sopko, George; Chandra-Strobos, Nisha; Urbina, Elaine M.; Vaccarino, Viola; Wenger, Nanette K.

doi:10.1161/cir.0b013e31820faaf8

Cited by 1,690 publications

(1,163 citation statements)

References 124 publications

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“…Unfortunately, evidence indicates that there is limited physician awareness of the future CVD risks associated with HDP and of the benefits of screening 72, 73. In 2011, the ACC/AHA published updated guidelines for the prevention of CVD in women that now include pregnancy history, including GH and preeclampsia, in the CVD risk assessment algorithm 74. The European Society of Cardiology and the National Institute for Health and Care Excellence also have guidelines for the management of arterial hypertension that discuss the need to recognize long‐term cardiovascular consequences of HDP 75, 76…”

Section: Current Guidelines and Recommendationsmentioning

confidence: 99%

Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk

Ying

Catov

Ouyang

2018

JAHA

Self Cite

181

119

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Section: Current Guidelines and Recommendationsmentioning

confidence: 99%

Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk

Ying

Catov

Ouyang

2018

JAHA

Self Cite

181

119

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“…De novo hypertensive disorders of pregnancy and gestational diabetes mellitus (GDM) are recognized as risk factors for premature maternal CVD 2. Evidence has also been accumulating on maternal CVD associated with other pregnancy‐related complications and outcomes,3 such as preterm delivery,4, 5, 6, 7, 8, 9, 10, 11 fetal growth restriction5, 7, 10, 12 placental abruption,13 and pregnancy losses 5, 14, 15, 16…”

Section: Introductionmentioning

confidence: 99%

Pregnancy‐Related Risk Factors Are Associated With a Significant Burden of Treated Hypertension Within 10 Years of Delivery: Findings From a Population‐Based Norwegian Cohort

Egeland

Staff

Eide

et al. 2018

JAHA

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BackgroundThe association between pregnancy complications and women's later cardiovascular disease has, primarily, been evaluated in studies lacking information on important covariates. This report evaluates the prospective associations between pregnancy‐related risk factors (preeclampsia/eclampsia, gestational hypertension, pregestational and gestational diabetes mellitus, preterm delivery, and fetal growth restriction) and pharmacologically treated hypertension within 10 years after pregnancy, while adjusting for a wide range of covariates.Methods and ResultsPrepregnancy normotensive women participating in the MoBa (Norwegian Mother and Child Cohort Study) from January 2004 through July 2009 were linked to the Norwegian Prescription Database to identify women with pharmacologically treated hypertension beyond the postpartum period of 3 months. The burden of hypertension associated with pregnancy‐related risk factors was evaluated using an attributable fraction method. A total of 1480 women developed pharmacologically treated hypertension within the follow‐up among 60 027 women (rate of hypertension, 3.6/1000 person‐years). The proportion of hypertension associated with a history of preeclampsia/eclampsia, gestational hypertension, preterm delivery, and pregestational or gestational diabetes mellitus was 28.6% (95% confidence interval, 25.5%–31.6%) on the basis of multivariable analyses adjusting for numerous covariates. The proportion was similar for women with a healthy prepregnancy body mass index (18.5‐24.9 kg/m2; attributable fraction (AF)% 25.9%; 95% confidence interval, 21.3%‐30.3%), but considerably higher for nulliparous women at baseline within the first 5 years of follow‐up. Small‐for‐gestational age, however, did not increase subsequent hypertension risk in multivariable analyses.ConclusionsA structured postpartum follow‐up of high‐risk women identified through pregnancy‐related risk factors would facilitate personalized preventive strategies to postpone or avoid onset of premature cardiovascular events.

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“…HDP may reveal a phenotype predisposed to CVD, and may therefore be used to identify women who would benefit from early screening and preventive efforts. A history of HDP has been included as a cardiovascular risk factor in CVD prevention guidelines in the United States since 20114 and in Europe since 2016 5. Yet there is little evidence and no consensus on how to tailor CVD screening and prevention in women with a history of HDP.…”

Section: Introductionmentioning

confidence: 99%

Life Course Trajectories of Cardiovascular Risk Factors in Women With and Without Hypertensive Disorders in First Pregnancy: The HUNT Study in Norway

Haug

Horn

Markovitz

et al. 2018

JAHA

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BackgroundWomen with hypertensive pregnancy disorders have adverse levels of cardiovascular risk factors. It is unclear how this adverse risk factor profile evolves during adult life. We compared life course trajectories of cardiovascular risk factors in women with preeclampsia or gestational hypertension in their first pregnancy to normotensive women.Methods and ResultsWe linked information on cardiovascular risk factors from the population‐based HUNT (Nord‐Trøndelag Health Study) surveys with pregnancy information from the Medical Birth Registry of Norway. Trajectories of cardiovascular risk factors were constructed for 22 308 women with a normotensive first pregnancy; 1092 with preeclampsia, and 478 with gestational hypertension in first pregnancy. Already before first pregnancy, women with preeclampsia in their first pregnancy had higher measures of adiposity, blood pressure, heart rate, and serum lipids and glucose compared with women with a normotensive first pregnancy. After first pregnancy, there was a parallel development in cardiovascular risk factor levels, but women with a normotensive first pregnancy had a time lag of >10 years compared with the preeclampsia group. There were no clear differences in risk factor trajectories between women with gestational hypertension and women with preeclampsia.ConclusionsWomen with hypertensive pregnancy disorders in their first pregnancy had an adverse cardiovascular risk factor profile before pregnancy compared with normotensive women, and the differences persisted beyond 50 years of age. Hypertensive disorders in pregnancy signal long‐term increases in modifiable cardiovascular risk factors, and may be used to identify women who would benefit from early prevention strategies.

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Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women—2011 Update

Cited by 1,690 publications

References 124 publications

Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk

Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk

Pregnancy‐Related Risk Factors Are Associated With a Significant Burden of Treated Hypertension Within 10 Years of Delivery: Findings From a Population‐Based Norwegian Cohort

Life Course Trajectories of Cardiovascular Risk Factors in Women With and Without Hypertensive Disorders in First Pregnancy: The HUNT Study in Norway

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