Postpartum evaluation of cardiovascular disease risk for women with pregnancies complicated by hypertension
Objectives: Postpartum stratification of cardiovascular risk for women with pregnancies complicated by pre-eclampsia is challenging. Our aim was to identify potential clinical and biomarker predictors of future cardiovascular risk at six weeks postpartum in women with hypertensive pregnancies. Stud...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2018
|
| Online Access: | https://eprints.nottingham.ac.uk/52905/ |
| _version_ | 1848798837008760832 |
|---|---|
| author | Escouto, Daniele Cristovao Green, Amanda Kurlak, Lesia Walker, Kate Loughna, Pamela Chappell, Lucy Broughton Pipkin, Fiona Bramham, Kate |
| author_facet | Escouto, Daniele Cristovao Green, Amanda Kurlak, Lesia Walker, Kate Loughna, Pamela Chappell, Lucy Broughton Pipkin, Fiona Bramham, Kate |
| author_sort | Escouto, Daniele Cristovao |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Objectives: Postpartum stratification of cardiovascular risk for women with pregnancies complicated by pre-eclampsia is challenging. Our aim was to identify potential clinical and biomarker predictors of future cardiovascular risk at six weeks postpartum in women with hypertensive pregnancies.
Study design: Prospective longitudinal cohort.
Main outcome measures: Ten year-Framingham cardiovascular risk scores were calculated for 477 women (94 with gestational hypertension, 288 with pre-eclampsia, 30 with superimposed pre-eclampsia, 51 with chronic hypertension, 14 women with uncomplicated pregnancies). B-type natriuretic peptide (BNP), neutrophil gelatinase–associated lipocalin (NGAL) and placental growth factor (PlGF) were quantified at six weeks postpartum.
Results: Framingham cardiovascular risk scores were not higher in women with pregnancies complicated by pre-eclampsia than healthy controls, nor were scores higher in women with pre-existing chronic hypertension complicated with superimposed pre-eclampsia compared with those without superimposed pre-eclampsia. Women with gestational hypertension had higher risk scores than women with pre-eclampsia and healthy controls. Established risk factors of cardiovascular disease including diastolic blood pressure and previously diagnosed chronic hypertension were associated with higher scores, and African ethnicity, parity and estimated glomerular filtration rate also were independently associated with higher Framingham risk scores at six weeks postpartum. PlGF, BNP and NGAL concentrations were not associated with Framingham cardiovascular risk scores after adjustment for independent variables.
Conclusions: A history of pre-eclampsia or superimposed pre-eclampsia in most recent pregnancy was not associated with elevated Framingham risk score at six weeks postpartum. Established clinical predictors may enable risk stratification at six weeks postpartum, which are not enhanced by the biomarkers included in this study. |
| first_indexed | 2025-11-14T20:26:07Z |
| format | Article |
| id | nottingham-52905 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T20:26:07Z |
| publishDate | 2018 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-529052019-06-30T04:30:12Z https://eprints.nottingham.ac.uk/52905/ Postpartum evaluation of cardiovascular disease risk for women with pregnancies complicated by hypertension Escouto, Daniele Cristovao Green, Amanda Kurlak, Lesia Walker, Kate Loughna, Pamela Chappell, Lucy Broughton Pipkin, Fiona Bramham, Kate Objectives: Postpartum stratification of cardiovascular risk for women with pregnancies complicated by pre-eclampsia is challenging. Our aim was to identify potential clinical and biomarker predictors of future cardiovascular risk at six weeks postpartum in women with hypertensive pregnancies. Study design: Prospective longitudinal cohort. Main outcome measures: Ten year-Framingham cardiovascular risk scores were calculated for 477 women (94 with gestational hypertension, 288 with pre-eclampsia, 30 with superimposed pre-eclampsia, 51 with chronic hypertension, 14 women with uncomplicated pregnancies). B-type natriuretic peptide (BNP), neutrophil gelatinase–associated lipocalin (NGAL) and placental growth factor (PlGF) were quantified at six weeks postpartum. Results: Framingham cardiovascular risk scores were not higher in women with pregnancies complicated by pre-eclampsia than healthy controls, nor were scores higher in women with pre-existing chronic hypertension complicated with superimposed pre-eclampsia compared with those without superimposed pre-eclampsia. Women with gestational hypertension had higher risk scores than women with pre-eclampsia and healthy controls. Established risk factors of cardiovascular disease including diastolic blood pressure and previously diagnosed chronic hypertension were associated with higher scores, and African ethnicity, parity and estimated glomerular filtration rate also were independently associated with higher Framingham risk scores at six weeks postpartum. PlGF, BNP and NGAL concentrations were not associated with Framingham cardiovascular risk scores after adjustment for independent variables. Conclusions: A history of pre-eclampsia or superimposed pre-eclampsia in most recent pregnancy was not associated with elevated Framingham risk score at six weeks postpartum. Established clinical predictors may enable risk stratification at six weeks postpartum, which are not enhanced by the biomarkers included in this study. Elsevier 2018-07-30 Article PeerReviewed application/pdf en cc_by_nc_nd https://eprints.nottingham.ac.uk/52905/7/Accepted%20Nottingham%20PDF%20Jul%202018.pdf Escouto, Daniele Cristovao, Green, Amanda, Kurlak, Lesia, Walker, Kate, Loughna, Pamela, Chappell, Lucy, Broughton Pipkin, Fiona and Bramham, Kate (2018) Postpartum evaluation of cardiovascular disease risk for women with pregnancies complicated by hypertension. Pregnancy Hypertension, 13 . pp. 218-224. ISSN 2210-7789 https://www.sciencedirect.com/science/article/pii/S221077891830031X?via%3Dihub doi:10.1016/j.preghy.2018.06.019 doi:10.1016/j.preghy.2018.06.019 |
| spellingShingle | Escouto, Daniele Cristovao Green, Amanda Kurlak, Lesia Walker, Kate Loughna, Pamela Chappell, Lucy Broughton Pipkin, Fiona Bramham, Kate Postpartum evaluation of cardiovascular disease risk for women with pregnancies complicated by hypertension |
| title | Postpartum evaluation of cardiovascular disease risk for women with pregnancies complicated by hypertension |
| title_full | Postpartum evaluation of cardiovascular disease risk for women with pregnancies complicated by hypertension |
| title_fullStr | Postpartum evaluation of cardiovascular disease risk for women with pregnancies complicated by hypertension |
| title_full_unstemmed | Postpartum evaluation of cardiovascular disease risk for women with pregnancies complicated by hypertension |
| title_short | Postpartum evaluation of cardiovascular disease risk for women with pregnancies complicated by hypertension |
| title_sort | postpartum evaluation of cardiovascular disease risk for women with pregnancies complicated by hypertension |
| url | https://eprints.nottingham.ac.uk/52905/ https://eprints.nottingham.ac.uk/52905/ https://eprints.nottingham.ac.uk/52905/ |