Cargando…
Recurrence of pre‐eclampsia and the risk of future hypertension and cardiovascular disease: a systematic review and meta‐analysis
BACKGROUND: Women with a history of hypertensive disorders, including pre‐eclampsia, during pregnancy have a two‐ to‐five‐fold increased risk of cardiovascular disease (CVD). In 15% of women, pre‐eclampsia recurs in the following pregnancy. OBJECTIVES: To evaluate all evidence on the future risk of...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283049/ https://www.ncbi.nlm.nih.gov/pubmed/29978553 http://dx.doi.org/10.1111/1471-0528.15394 |
_version_ | 1783379115213062144 |
---|---|
author | Brouwers, L van der Meiden‐van Roest, AJ Savelkoul, C Vogelvang, TE Lely, AT Franx, A van Rijn, BB |
author_facet | Brouwers, L van der Meiden‐van Roest, AJ Savelkoul, C Vogelvang, TE Lely, AT Franx, A van Rijn, BB |
author_sort | Brouwers, L |
collection | PubMed |
description | BACKGROUND: Women with a history of hypertensive disorders, including pre‐eclampsia, during pregnancy have a two‐ to‐five‐fold increased risk of cardiovascular disease (CVD). In 15% of women, pre‐eclampsia recurs in the following pregnancy. OBJECTIVES: To evaluate all evidence on the future risk of developing hypertension and CVD after multiple pregnancies complicated by pre‐eclampsia compared with pre‐eclampsia in a single pregnancy followed by normal subsequent pregnancy. SEARCH STRATEGY: Embase and Medline were searched until June 2017. SELECTION CRITERIA: All relevant studies on the risk of developing hypertension, atherosclerosis, ischaemic heart disease, cerebrovascular accident (CVA), thromboembolism, heart failure or overall hospitalisation and mortality due to CVD after having had recurrent pre‐eclampsia. DATA COLLECTION AND ANALYSIS: Twenty‐two studies were included in the review. When possible, we calculated pooled risk ratios (RR) with 95% CI through random‐effect analysis. MAIN RESULTS: Recurrent pre‐eclampsia was consistently associated with an increased pooled risk ratio of hypertension (RR 2.3; 95% CI 1.9–2.9), ischaemic heart disease (RR 2.4; 95% CI 2.2–2.7), heart failure (RR 2.9; 95% CI 2.3–3.7), CVA (RR 1.7; 95% CI 1.2–2.6) and hospitalisation due to CVD (RR 1.6; 95% CI 1.3–1.9) when compared with women with subsequent uncomplicated pregnancies. Other studies on thromboembolism, atherosclerosis and cardiovascular mortality found a positive effect, but data could not be pooled. CONCLUSIONS: This systematic review and meta‐analysis support consistent higher risk for future development of hypertension and CVD in women with recurring pre‐eclampsia as opposed to women with a single episode of pre‐eclampsia. TWEETABLE ABSTRACT: The risk of future cardiovascular disease increases when women have recurrence of pre‐eclampsia compared with a single episode. |
format | Online Article Text |
id | pubmed-6283049 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-62830492018-12-14 Recurrence of pre‐eclampsia and the risk of future hypertension and cardiovascular disease: a systematic review and meta‐analysis Brouwers, L van der Meiden‐van Roest, AJ Savelkoul, C Vogelvang, TE Lely, AT Franx, A van Rijn, BB BJOG Systematic Review BACKGROUND: Women with a history of hypertensive disorders, including pre‐eclampsia, during pregnancy have a two‐ to‐five‐fold increased risk of cardiovascular disease (CVD). In 15% of women, pre‐eclampsia recurs in the following pregnancy. OBJECTIVES: To evaluate all evidence on the future risk of developing hypertension and CVD after multiple pregnancies complicated by pre‐eclampsia compared with pre‐eclampsia in a single pregnancy followed by normal subsequent pregnancy. SEARCH STRATEGY: Embase and Medline were searched until June 2017. SELECTION CRITERIA: All relevant studies on the risk of developing hypertension, atherosclerosis, ischaemic heart disease, cerebrovascular accident (CVA), thromboembolism, heart failure or overall hospitalisation and mortality due to CVD after having had recurrent pre‐eclampsia. DATA COLLECTION AND ANALYSIS: Twenty‐two studies were included in the review. When possible, we calculated pooled risk ratios (RR) with 95% CI through random‐effect analysis. MAIN RESULTS: Recurrent pre‐eclampsia was consistently associated with an increased pooled risk ratio of hypertension (RR 2.3; 95% CI 1.9–2.9), ischaemic heart disease (RR 2.4; 95% CI 2.2–2.7), heart failure (RR 2.9; 95% CI 2.3–3.7), CVA (RR 1.7; 95% CI 1.2–2.6) and hospitalisation due to CVD (RR 1.6; 95% CI 1.3–1.9) when compared with women with subsequent uncomplicated pregnancies. Other studies on thromboembolism, atherosclerosis and cardiovascular mortality found a positive effect, but data could not be pooled. CONCLUSIONS: This systematic review and meta‐analysis support consistent higher risk for future development of hypertension and CVD in women with recurring pre‐eclampsia as opposed to women with a single episode of pre‐eclampsia. TWEETABLE ABSTRACT: The risk of future cardiovascular disease increases when women have recurrence of pre‐eclampsia compared with a single episode. John Wiley and Sons Inc. 2018-08-10 2018-12 /pmc/articles/PMC6283049/ /pubmed/29978553 http://dx.doi.org/10.1111/1471-0528.15394 Text en © 2018 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Systematic Review Brouwers, L van der Meiden‐van Roest, AJ Savelkoul, C Vogelvang, TE Lely, AT Franx, A van Rijn, BB Recurrence of pre‐eclampsia and the risk of future hypertension and cardiovascular disease: a systematic review and meta‐analysis |
title | Recurrence of pre‐eclampsia and the risk of future hypertension and cardiovascular disease: a systematic review and meta‐analysis |
title_full | Recurrence of pre‐eclampsia and the risk of future hypertension and cardiovascular disease: a systematic review and meta‐analysis |
title_fullStr | Recurrence of pre‐eclampsia and the risk of future hypertension and cardiovascular disease: a systematic review and meta‐analysis |
title_full_unstemmed | Recurrence of pre‐eclampsia and the risk of future hypertension and cardiovascular disease: a systematic review and meta‐analysis |
title_short | Recurrence of pre‐eclampsia and the risk of future hypertension and cardiovascular disease: a systematic review and meta‐analysis |
title_sort | recurrence of pre‐eclampsia and the risk of future hypertension and cardiovascular disease: a systematic review and meta‐analysis |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283049/ https://www.ncbi.nlm.nih.gov/pubmed/29978553 http://dx.doi.org/10.1111/1471-0528.15394 |
work_keys_str_mv | AT brouwersl recurrenceofpreeclampsiaandtheriskoffuturehypertensionandcardiovasculardiseaseasystematicreviewandmetaanalysis AT vandermeidenvanroestaj recurrenceofpreeclampsiaandtheriskoffuturehypertensionandcardiovasculardiseaseasystematicreviewandmetaanalysis AT savelkoulc recurrenceofpreeclampsiaandtheriskoffuturehypertensionandcardiovasculardiseaseasystematicreviewandmetaanalysis AT vogelvangte recurrenceofpreeclampsiaandtheriskoffuturehypertensionandcardiovasculardiseaseasystematicreviewandmetaanalysis AT lelyat recurrenceofpreeclampsiaandtheriskoffuturehypertensionandcardiovasculardiseaseasystematicreviewandmetaanalysis AT franxa recurrenceofpreeclampsiaandtheriskoffuturehypertensionandcardiovasculardiseaseasystematicreviewandmetaanalysis AT vanrijnbb recurrenceofpreeclampsiaandtheriskoffuturehypertensionandcardiovasculardiseaseasystematicreviewandmetaanalysis |