A senhora teve hipertensão durante a primeira gravidez?

Uma pergunta simples que de acordo com um estudo recentemente publicado- J Am Heart Assoc. 2018 Aug 7;7(15):e009250- esta pergunta permite identificar as mulheres com um perfil de risco cardiovascular adverso em comparação mulheres normotensas, e as diferenças persistiram além dos 50 anos de idade. A hipertensão na gravidez sinaliza aumentos a longo prazo fatores de risco cardiovascular, e pode ser usado para identificar mulheres que se beneficiariam de estratégias de prevenção precoce.

Life Course Trajectories of Cardiovascular Risk Factors in Women With and Without Hypertensive Disorders in First Pregnancy: The HUNT Study in Norway.

Haug EB(1), Horn J(1)(2), Markovitz AR(3)(4), Fraser A(5), Vatten LJ(1), Macdonald-Wallis C(5), Tilling K(5), Romundstad PR(1), Rich-Edwards JW(3)(4), Åsvold BO(1)(6).

BACKGROUND: Women with hypertensive pregnancy disorders have adverse levels of cardiovascular risk factors. It is unclear how this adverse risk factor profile evolves during adult life. We compared life course trajectories of cardiovascular risk factors in women with preeclampsia or gestational hypertension in their first pregnancy to normotensive women. Methods and Results We linked information  on cardiovascular risk factors from the population-based HUNT (Nord-Trøndelag Health Study) surveys with pregnancy information from the Medical Birth Registry  of Norway. Trajectories of cardiovascular risk factors were constructed for 22 308 women with a normotensive first pregnancy; 1092 with preeclampsia, and 478 with gestational hypertension in first pregnancy. Already before first pregnancy, women with preeclampsia in their first pregnancy had higher measures of

adiposity, blood pressure, heart rate, and serum lipids and glucose compared with women with a normotensive first pregnancy. After first pregnancy, there was a parallel development in cardiovascular risk factor levels, but women with a normotensive first pregnancy had a time lag of >10 years compared with the preeclampsia group. There were no clear differences in risk factor trajectories between women with gestational hypertension and women with preeclampsia.

CONCLUSIONS: Women with hypertensive pregnancy disorders in their first pregnancy  had an adverse cardiovascular risk factor profile before pregnancy compared with  normotensive women, and the differences persisted beyond 50 years of age. Hypertensive disorders in pregnancy signal long-term increases in modifiable cardiovascular risk factors, and may be used to identify women who would benefit from early prevention strategies.