Hypertension (Dallas, Tex. : 1979) · 2026
Subtypes of Hypertension 2 to 7 Years After First Pregnancy.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Brubaker Laura H, Catov Janet M, Bairey Merz C Noel, Barnes Shannon, Barone Gibbs Bethany, Booker Whitney, Chung Judith H, Greenland Philip, Grobman William A, Khan Sadiya S, Lane Abbi, Levine Lisa D, McNeil Rebecca B, Miller Eliza C, Muldoon Matthew F, Ray Mitali, Saade George R, Scifres Christina M, Silver Robert M, Simhan Hyagriv, Yee Lynn M, Hauspurg Alisse
Аннотация
BACKGROUND: Isolated diastolic hypertension can precede combined systolic-diastolic hypertension, suggesting isolated diastolic hypertension may be a risk factor for adverse cardiovascular outcomes. Little is known about the prevalence of hypertensive subtypes (isolated diastolic, isolated systolic, or combined systolic-diastolic hypertension) in the years after first pregnancy, and whether these differ after hypertensive disorder of pregnancy.
METHODS: This is a secondary analysis (conducted 2023-2024) of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be Heart Health Study. Nulliparas were enrolled at 8 US clinical sites from 2010 to 2013; participants who completed the Heart Health Study visit 2 to 7 years after pregnancy were eligible. Blood pressures were elevated at the visit if systolic was ≥130 mm Hg and diastolic ≥80 mm Hg. Multinomial logistic regression relative risk models were adjusted for age, body mass index, race, and time from pregnancy to visit.
RESULTS: Four thousand three hundred two participants were included. Mean age at Heart Health Study visit was 30.7 years (SD, 5.6 years); 812 (19%) had elevated blood pressure. Isolated diastolic hypertension was most prevalent (n=627; 15%). Compared with normotensive pregnancy, hypertensive disorders of pregnancy were associated with combined systolic-diastolic (adjusted risk ratio, 3.09 [95% CI, 2.21-4.31]) and isolated diastolic hypertension (adjusted risk ratio, 1.65 [95% CI, 1.36-2.00]).
CONCLUSIONS: Isolated diastolic hypertension is the most prevalent hypertensive subtype after first pregnancy. Women with hypertensive disorders of pregnancy had increased risk of combined systolic-diastolic and isolated diastolic hypertension. Given the high prevalence of isolated diastolic hypertension found in this cohort, postpartum women represent a subgroup with opportunity for cardiovascular risk reduction.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02231398.
METHODS: This is a secondary analysis (conducted 2023-2024) of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be Heart Health Study. Nulliparas were enrolled at 8 US clinical sites from 2010 to 2013; participants who completed the Heart Health Study visit 2 to 7 years after pregnancy were eligible. Blood pressures were elevated at the visit if systolic was ≥130 mm Hg and diastolic ≥80 mm Hg. Multinomial logistic regression relative risk models were adjusted for age, body mass index, race, and time from pregnancy to visit.
RESULTS: Four thousand three hundred two participants were included. Mean age at Heart Health Study visit was 30.7 years (SD, 5.6 years); 812 (19%) had elevated blood pressure. Isolated diastolic hypertension was most prevalent (n=627; 15%). Compared with normotensive pregnancy, hypertensive disorders of pregnancy were associated with combined systolic-diastolic (adjusted risk ratio, 3.09 [95% CI, 2.21-4.31]) and isolated diastolic hypertension (adjusted risk ratio, 1.65 [95% CI, 1.36-2.00]).
CONCLUSIONS: Isolated diastolic hypertension is the most prevalent hypertensive subtype after first pregnancy. Women with hypertensive disorders of pregnancy had increased risk of combined systolic-diastolic and isolated diastolic hypertension. Given the high prevalence of isolated diastolic hypertension found in this cohort, postpartum women represent a subgroup with opportunity for cardiovascular risk reduction.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02231398.