Synergistic effect of gestational hypertension and postpartum incident hypertension on cardiovascular health: A nationwide population study

Jong Shiuan Yeh, Hao Min Cheng, Pai Feng Hsu, Shih Hsien Sung, Wen Ling Liu, Hsin Ling Fang, Shao Yuan Chuang

研究成果: 雜誌貢獻文章

6 引文 (Scopus)

摘要

Background-Gestational hypertension (GH) is a common complication of pregnancy and is associated with increased risk of incident hypertension in later life (IH) and cardiovascular events. However, the interactive effect of GH and IH on postpartum cardiovascular health remains unclear. Methods and Results-A nationwide population-based study was conducted using 1 million individuals from the Taiwan National Health Insurance database. Records from 1998 to 2009 were used to identify 1260 pregnant women with GH and without previous cardiovascular disease. The control group comprised 5040 pregnant women without GH, matched for age and date of delivery. During the follow-up period (median duration, 5.8 years), 182 cardiovascular events developed. Women with GH had significantly higher risk of cardiovascular events (hazard ratio [95% CI], 2.44 [1.80 to 3.31]) and IH (8.29 [6.30 to 10.91]) than controls. Compared with women without GH and IH, there was a significantly higher risk of cardiovascular events for women without GH but with IH (relative risk [95% CI], 2.89 [1.27-6.58]), women with GH but without IH (1.66 [1.16-2.39]), and women with GH and IH (8.11 [5.36-12.30]). The synergy index was 2.91 (95% CI 1.11 to 7.59), suggesting a positive interaction between GH and IH. Conclusions-GH increased the risk of subsequent IH. Women with both GH and IH were at a substantially higher cardiovascular risk than were women with either GH or IH. The synergistic adverse effect of GH and IH on postpartum cardiovascular health indicates that more attention should be paid to this special population.

原文英語
文章編號001008
期刊Journal of the American Heart Association
3
發行號6
DOIs
出版狀態已發佈 - 2014

指紋

Pregnancy Induced Hypertension
Postpartum Period
Hypertension
Health
Population
Pregnant Women
Pregnancy Complications
National Health Programs
Taiwan

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

引用此文

Synergistic effect of gestational hypertension and postpartum incident hypertension on cardiovascular health : A nationwide population study. / Yeh, Jong Shiuan; Cheng, Hao Min; Hsu, Pai Feng; Sung, Shih Hsien; Liu, Wen Ling; Fang, Hsin Ling; Chuang, Shao Yuan.

於: Journal of the American Heart Association, 卷 3, 編號 6, 001008, 2014.

研究成果: 雜誌貢獻文章

Yeh, Jong Shiuan ; Cheng, Hao Min ; Hsu, Pai Feng ; Sung, Shih Hsien ; Liu, Wen Ling ; Fang, Hsin Ling ; Chuang, Shao Yuan. / Synergistic effect of gestational hypertension and postpartum incident hypertension on cardiovascular health : A nationwide population study. 於: Journal of the American Heart Association. 2014 ; 卷 3, 編號 6.
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title = "Synergistic effect of gestational hypertension and postpartum incident hypertension on cardiovascular health: A nationwide population study",
abstract = "Background-Gestational hypertension (GH) is a common complication of pregnancy and is associated with increased risk of incident hypertension in later life (IH) and cardiovascular events. However, the interactive effect of GH and IH on postpartum cardiovascular health remains unclear. Methods and Results-A nationwide population-based study was conducted using 1 million individuals from the Taiwan National Health Insurance database. Records from 1998 to 2009 were used to identify 1260 pregnant women with GH and without previous cardiovascular disease. The control group comprised 5040 pregnant women without GH, matched for age and date of delivery. During the follow-up period (median duration, 5.8 years), 182 cardiovascular events developed. Women with GH had significantly higher risk of cardiovascular events (hazard ratio [95{\%} CI], 2.44 [1.80 to 3.31]) and IH (8.29 [6.30 to 10.91]) than controls. Compared with women without GH and IH, there was a significantly higher risk of cardiovascular events for women without GH but with IH (relative risk [95{\%} CI], 2.89 [1.27-6.58]), women with GH but without IH (1.66 [1.16-2.39]), and women with GH and IH (8.11 [5.36-12.30]). The synergy index was 2.91 (95{\%} CI 1.11 to 7.59), suggesting a positive interaction between GH and IH. Conclusions-GH increased the risk of subsequent IH. Women with both GH and IH were at a substantially higher cardiovascular risk than were women with either GH or IH. The synergistic adverse effect of GH and IH on postpartum cardiovascular health indicates that more attention should be paid to this special population.",
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AB - Background-Gestational hypertension (GH) is a common complication of pregnancy and is associated with increased risk of incident hypertension in later life (IH) and cardiovascular events. However, the interactive effect of GH and IH on postpartum cardiovascular health remains unclear. Methods and Results-A nationwide population-based study was conducted using 1 million individuals from the Taiwan National Health Insurance database. Records from 1998 to 2009 were used to identify 1260 pregnant women with GH and without previous cardiovascular disease. The control group comprised 5040 pregnant women without GH, matched for age and date of delivery. During the follow-up period (median duration, 5.8 years), 182 cardiovascular events developed. Women with GH had significantly higher risk of cardiovascular events (hazard ratio [95% CI], 2.44 [1.80 to 3.31]) and IH (8.29 [6.30 to 10.91]) than controls. Compared with women without GH and IH, there was a significantly higher risk of cardiovascular events for women without GH but with IH (relative risk [95% CI], 2.89 [1.27-6.58]), women with GH but without IH (1.66 [1.16-2.39]), and women with GH and IH (8.11 [5.36-12.30]). The synergy index was 2.91 (95% CI 1.11 to 7.59), suggesting a positive interaction between GH and IH. Conclusions-GH increased the risk of subsequent IH. Women with both GH and IH were at a substantially higher cardiovascular risk than were women with either GH or IH. The synergistic adverse effect of GH and IH on postpartum cardiovascular health indicates that more attention should be paid to this special population.

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