Long-Term Cardiovascular Risks Associated With Adverse Pregnancy Outcomes

Lane‐Cordova, Abbi D.; Khan, Sadiya S.; Grobman, William A.; Greenland, Philip; Shah, Sanjiv J.

doi:10.1016/j.jacc.2018.12.092

Cited by 176 publications

(179 citation statements)

References 78 publications

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“…Pregnancy, now commonly referred to as a "women's first stress test" and related APOs put women at increased risk for future CVD. 9 In a recent comprehensive review on the long-term CV risk associated with APOs, Lane-Cordova et al report that the vascular abnormalities that are present during an APO (e.g., hypertension, pre-eclampsia, or gestational diabetes) also underlie common, difficult-to-treat forms of CVD in women as they age, including coronary microvascular disease, suggesting shared mechanistic pathways for APOs and CVD. 9 At present, there are no studies addressing the impact of APOs on ischemia and no obstructive coronary artery disease.…”

Section: Sex Differences Unique To Women With Cvdmentioning

confidence: 99%

Introducing the Canadian Women’s Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Diseases in Women

et al. 2020

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Despite a global understanding that indicators and outcomes of cardiovascular disease (CVD) are known to differ between men and women, uptake of the recognition of sex and gender influences on the clinical care of women has been slow or absent. The Canadian Women's Heart Health Alliance (CWHHA) was established as a network of experts and advocates to develop and disseminate evidence-informed strategies to transform clinical practice and augment collaborative action on women's cardiovascular health in Canada. As an initial project, the CWHHA membership undertook an environmental scan of CVD in women in Canada from which a scientific statement could be developed to summarize critical sex-and gender-specific issues in CVD. This comprehensive review of the CJC Open 2 (2020) 145e150

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Section: Sex Differences Unique To Women With Cvdmentioning

confidence: 99%

Introducing the Canadian Women’s Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Diseases in Women

et al. 2020

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“…Considering that women who experience preeclampsia during pregnancy have higher burden of cardiovascular complications later in life (16), in this study we identified a number of overlapping molecular pathways between preeclampsia and CVD i.e. hypertension and…”

Section: Overlapping Pathophysiological Mechanisms Between Preeclampsmentioning

confidence: 99%

Overlapping Pathogenic Signalling Pathways and Biomarkers in Preeclampsia and Cardiovascular Disease

Šuvakov

Bonner

Nikolić

et al. 2020

Preprint

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Corresponding authorsHighlights  Women with preeclampsia have increased risk of cardiovascular disease later in life but the mechanism is poorly understood. "In silico" analyses of publically available datasets provided overlapping biomarkers and pathogenic pathways between preeclampsia, hypertension and heart failure with preserved ejection fraction (HFpEF). These data could be utilised in the future studies that may lead to the development of better risk stratification strategies or preventative treatments for women post preeclampsia. AbstractObjectives: Preeclampsia is a cardiovascular pregnancy complication which occurs in 5-10% of pregnancies that can lead to a number of pregnancy complications including maternal and foetal death. Long-term, preeclampsia is associated with up to 8-fold increased risk of cardiovascular disease (CVD) for both mothers and their offspring. The lack of mechanistic data in relation to the causes or consequences of preeclampsia has prevented the development of effective therapeutic or monitoring strategies. Study design:This study investigates common underlying mechanisms of preeclampsia and CVD, specifically hypertension and heart failure with preserved ejection fraction (HFpEF)using "in silico" approach of publicly available datasets. Integrated techniques were designed to mine data repositories and identify relevant biomarkers associated with these three conditions. Main outcomes measures:The knowledge base tools were employed that enabled the analysis of these biomarkers to discover potential molecular and biological links between these three conditions.Results: Our bioinformatics "in silico" analyses of the publically available datasets identified 76 common biomarkers between preeclampsia, hypertension and HFpEF. These biomarkers were representative of 29 pathways commonly enriched across the three conditions which were largely related to inflammation, metabolism, angiogenesis, remodelling, haemostasis, apoptosis, endoplasmic reticulum (ER) stress signalling and the renin-angiotensin-aldosterone (RAAS) system. Conclusions:This bioinformatics approach which uses the wealth of scientific data available in public repositories can be helpful to gain a deeper understanding of the overlapping pathogenic mechanisms of associated diseases, which could be explored as biomarkers or targets to prevent long-term cardiovascular complications such as hypertension and HFpEF following preeclampsia. Abstract word count: 244 wordsMain text word count: 2580 words Total word count: 4653 words

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“…Pregnancy is associated with profound cardiovascular changes in women, and pregnancy-related pathologies, such as hypertensive disorders of pregnancy, intrauterine growth restriction, and preterm birth, are associated with excess lifelong CVD risk ( 37 ). Given that BP tends to go back to the normotensive range, even after hypertensive disorders of pregnancy, and that preterm birth or intrauterine growth restriction can occur even when the mother is normotensive throughout pregnancy, BP alone might not identify women who are progressing toward CVD after an adverse pregnancy outcome ( 37 ). More sensitive measures of vascular function are warranted during and after pregnancy ( 38 ).…”

Section: Considerations For Data Collection In Premenopausal Womenmentioning

confidence: 99%

Importance of Sensitive Vascular Measurements for Evaluating Effects of Lifestyle in Premenopausal Women

Lane‐Cordova

Bouknight

2020

Front. Cardiovasc. Med.

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Premenopausal women generally have a favorable cardiovascular risk profile, owing to young age and the protective effects of estrogen. Rates of hypertension and more advanced cardiovascular disease (CVD) are low in premenopausal women. A large body of epidemiological evidence has shown that lifestyle behaviors in midlife, i.e., cardiorespiratory fitness, physical activity, and healthy diet, are associated with lower risk of overt CVD and adverse cardiovascular outcomes in the future for men and women. Despite differences in future cardiovascular risk, brachial blood pressures might be similar between premenopausal women with favorable vs. unfavorable levels of lifestyle behaviors in early-to-mid-life. Here we make the case for deeper phenotyping by means of vascular function measurements, such as arterial stiffness, augmentation index, and endothelial function, to identify potential mechanistic pathways linking lifestyle behaviors in early-to-mid-adulthood with lifelong CVD risk in women. We describe considerations for vascular function measurement in premenopausal women and opportunities for investigators to fill in knowledge gaps to further our understanding of CVD risk assessment and CVD progression in premenopausal women.

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Long-Term Cardiovascular Risks Associated With Adverse Pregnancy Outcomes

Cited by 176 publications

References 78 publications

Introducing the Canadian Women’s Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Diseases in Women

Introducing the Canadian Women’s Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Diseases in Women

Overlapping Pathogenic Signalling Pathways and Biomarkers in Preeclampsia and Cardiovascular Disease

Importance of Sensitive Vascular Measurements for Evaluating Effects of Lifestyle in Premenopausal Women

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