TY - JOUR
T1 - Long-Term Cardiovascular Risks Associated With Adverse Pregnancy Outcomes
T2 - JACC Review Topic of the Week
AU - Lane-Cordova, Abbi D.
AU - Khan, Sadiya S.
AU - Grobman, William A.
AU - Greenland, Philip
AU - Shah, Sanjiv J.
N1 - Funding Information:
Drs. Lane-Cordova and Greenland were funded through the American Heart Association (AHA)’s Strategically Focused Research Network (SFRN) in Prevention grant 14SFRN20480260. Dr. Khan was funded by the National Institutes of Health (NIH) National Center for Advancing Translational Sciences grant KL2TR001424. Drs. Grobman and Greenland were funded by NIH grant U10 HL119992. Dr. Shah was funded by NIH grants R01 HL127028, R01 HL107577, and R01 HL140731, and an AHA Go Red for Women SFRN grant (16SFRN28780016).
Publisher Copyright:
© 2019
PY - 2019/4/30
Y1 - 2019/4/30
N2 - Adverse pregnancy outcomes (APOs)—including pre-term birth, pre-eclampsia, and intrauterine growth restriction—are common interrelated disorders caused by placental dysfunction and maternal vascular abnormalities (endothelial activation, inflammation, and vasospasm) that occur in approximately 10% to 20% of pregnancies. Women who experience APOs are at increased risk for future cardiovascular disease (CVD). APOs are associated with increased risk of development of hypertension, left ventricular hypertrophy/dysfunction, vascular dysfunction, and renal dysfunction. The vascular abnormalities that are present during an APO also underlie common, difficult-to-treat forms of CVD in women as they age (e.g., cardiac microvascular dysfunction, heart failure with preserved ejection fraction), suggesting shared mechanistic pathways for APOs and CVD. Here, the authors synthesize the current information and knowledge gaps regarding the progression from APO to CVD. Understanding the risk factors for and pathogenesis of APO-related cardiovascular dysfunction is a critical unmet need that could inform efforts to prevent and more effectively treat CVD in women.
AB - Adverse pregnancy outcomes (APOs)—including pre-term birth, pre-eclampsia, and intrauterine growth restriction—are common interrelated disorders caused by placental dysfunction and maternal vascular abnormalities (endothelial activation, inflammation, and vasospasm) that occur in approximately 10% to 20% of pregnancies. Women who experience APOs are at increased risk for future cardiovascular disease (CVD). APOs are associated with increased risk of development of hypertension, left ventricular hypertrophy/dysfunction, vascular dysfunction, and renal dysfunction. The vascular abnormalities that are present during an APO also underlie common, difficult-to-treat forms of CVD in women as they age (e.g., cardiac microvascular dysfunction, heart failure with preserved ejection fraction), suggesting shared mechanistic pathways for APOs and CVD. Here, the authors synthesize the current information and knowledge gaps regarding the progression from APO to CVD. Understanding the risk factors for and pathogenesis of APO-related cardiovascular dysfunction is a critical unmet need that could inform efforts to prevent and more effectively treat CVD in women.
KW - myocardial dysfunction
KW - placenta
KW - pre-eclampsia
KW - pregnancy
KW - vascular dysfunction
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U2 - 10.1016/j.jacc.2018.12.092
DO - 10.1016/j.jacc.2018.12.092
M3 - Review article
C2 - 31023435
AN - SCOPUS:85064190451
SN - 0735-1097
VL - 73
SP - 2106
EP - 2116
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 16
ER -
