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Am J Obstet Gynecol:先兆子痫史女性,警惕心血管事件的发生

2016-04-05 MedSci MedSci原创

背景:先兆子痫史是心血管事件和卒中发生的独立危险因素。血管结构的改变是否与此相关尚不清楚。目的:进行前瞻性队列研究,确定有无先兆子痫史的女性冠状动脉钙化(CAC)的程度。CAC是已知的心血管事件的危险因素。研究设计:从1976年到1982间住在明尼苏达奥姆斯特德县的女性中,招募无心血管事件的女性(40例无先兆子痫史的女性,40例先兆子痫的女性)。CT检查CAC。从医疗记录中获得所有的妊娠史和协变量

背景:先兆子痫史是心血管事件和卒中发生的独立危险因素。血管结构的改变是否与此相关尚不清楚。

目的:进行前瞻性队列研究,确定有无先兆子痫史的女性冠状动脉钙化(CAC)的程度。CAC是已知的心血管事件的危险因素。

研究设计:从1976年到1982间住在明尼苏达奥姆斯特德县的女性中,招募无心血管事件的女性(40例无先兆子痫史的女性,40例先兆子痫的女性)。CT检查CAC。从医疗记录中获得所有的妊娠史和协变量。在进行影像学扫描时评估临床变量。应用卡方检验比较有无先兆子痫史的差异。尤其是CAC作为分类有序变量,应用卡方检验,Wilcoxon两样本检验和logistic回归进行分析。

结果:平均年龄(SD)为59.5(±4.6)岁。有无先兆子痫的两组女性的收缩压和舒张压,高脂血症和糖尿病之间没有差异。然而,与对照组相比,先兆子痫史女性,诊断为高血压的认识较多(60% vs 20%),MBI较高【29.8(25.9-33.7)VS25.3 (23.1-32.0)】。先兆子痫史女性CAC分数>50 Agatston者较多(23% vs 0%)。未校正高血压时,先兆子痫史女性高CAC分数的比率是无先兆子痫女性3.54(CI:1.39-9.02)倍,校正高血压后,先兆子痫史史高CAC分数的比率是无先兆子痫女性的2.61 (CI, 0.95-7.14)。校正BMI后,先兆子痫史的女性高CAC的比率为3.20(CI,1.21-8.49)。

结论:在这项前瞻性队列研究中,通过医疗记录确定先兆子痫的存在,即使控制单独的传统危险因素,先兆子痫史与妊娠后30年后CAC风险增加相关。在减少女性心血管疾病的预防措施中,应该将先兆子痫史作为危险因素进行评估。在先兆子痫史的女性总,CAC可能是心血管事件的高危因素,是未来研究的主题。

原文出处:

White WM, Mielke MM, et al.
A history of preeclampsia is associated with a risk for coronary artery calcification 3 decades later. Am J Obstet Gynecol. 2016 Apr.

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    2016-09-12 yhy100200
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    2016-04-06 dhzzm

    值得学习,很好

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2011239, encodeId=940d2011239b1, content=<a href='/topic/show?id=840d1e300e5' target=_blank style='color:#2F92EE;'>#TET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17300, encryptionId=840d1e300e5, topicName=TET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cc52251, createdName=yhy100200, createdTime=Mon Sep 12 20:22:00 CST 2016, time=2016-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643404, encodeId=bb0e164340404, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Fri Jun 10 04:22:00 CST 2016, time=2016-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043903, encodeId=fa722043903b4, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Mon Jun 27 14:22:00 CST 2016, time=2016-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76040, encodeId=e007e6040a1, content=值得学习,很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=185, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Wed Apr 06 15:45:00 CST 2016, time=2016-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=75761, encodeId=3efce5761b1, content=发生子痫前期的根本原因本身与心血管事件有木有联系, beContent=null, objectType=article, channel=null, level=null, likeNumber=165, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIuqOuvZLWMJ8yAVHKNPBSKWLKHx7ibIhutJv2OfnTK9MQH5jpicpw5EJTmD0M0q2wOG3CZO9wTxa9A/132, createdBy=75561684788, createdName=yilibaisha, createdTime=Wed Apr 06 09:18:00 CST 2016, time=2016-04-06, status=1, ipAttribution=)]
    2016-04-06 yilibaisha

    发生子痫前期的根本原因本身与心血管事件有木有联系

    0

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JACC:高血压患者可通过早晨家庭血压(HBP)预测心血管事件的发生

很少有研究评估办公室外的血压(BP)作为冠状动脉疾病(CAD)事件的预测因子。本研究的目的是要确定早晨家庭血压(HBP)作为心血管事件的预测因子。研究人员使用来自HONEST(未建立标准目标血压患者的家庭血压测量)研究的数据,检测了早晨HBP和卒中以及CAD事件发生率之间的关系。在21591例接受治疗的高血压患者中(平均年龄64.9岁;平均随访2.02年),共发生127例脑卒中事件(每1000病人

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