10-Year cardiovascular event risks for women who experienced hypertensive disorders in late pregnancy: the HyRAS study.
BACKGROUND
Cardiovascular disease is the cause of death in 32% of women in the Netherlands. Prediction of an individual's risk for cardiovascular disease is difficult, in particular in younger women due to low sensitive and specific tests for these women. 10% to 15% of all pregnancies are complicated by hypertensive disorders, the vast majority of which develop only after 36 weeks of gestation. Preeclampsia and cardiovascular disease in later life show both features of "the metabolic syndrome" and atherosclerosis. Hypertensive disorders in pregnancy and cardiovascular disease may develop by common pathophysiologic pathways initiated by similar vascular risk factors. Vascular damage occurring during preeclampsia or gestational hypertension may contribute to the development of future cardiovascular disease, or is already present before pregnancy. At present clinicians do not systematically aim at the possible cardiovascular consequences in later life after a hypertensive pregnancy disorder at term. However, screening for risk factors after preeclampsia or gestational hypertension at term may give insight into an individual's cardiovascular risk profile.


METHODS
Women with a history of preeclampsia or gestational hypertension will be invited to participate in a cohort study 2 1/2 years after delivery. Participants will be screened for established modifiable cardiovascular risk indicators. The primary outcome is the 10-year cardiovascular event risk. Secondary outcomes include differences in cardiovascular parameters, SNP's in glucose metabolism, and neonatal outcome.


CONCLUSIONS
This study will provide evidence on the potential health gains of a modifiable cardiovascular risk factor screening program for women whose pregnancy was complicated by hypertension or preeclampsia. The calculation of individual 10-year cardiovascular event risks will allow identification of those women who will benefit from primary prevention by tailored interventions, at a relatively young age.


BACKGROUND
The HYPITAT trial is registered in the clinical trial register as ISRCTN08132825.
Hermes
Wietske
W
Department of Obstetrics and Gynecology, Medical Centre Haaglanden Den Haag, the Netherlands. wietskehermes@hotmail.com
Franx
Arie
A
van Pampus
Maria G
MG
Bloemenkamp
Kitty W
KW
van der Post
Joris A
JA
Porath
Martina
M
Ponjee
Gabrielle
G
Tamsma
Jouke T
JT
Mol
Ben W
BW
de Groot
Christianne J
CJ
D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology / Q000517:prevention & control; D016015:Logistic Models; D008403:Mass Screening / Q000458:organization & administration*; D009426:Netherlands / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011322:Primary Prevention; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment / Q000458:organization & administration*; D012307:Risk Factors