Cardiovascular Prevention and Pharmacotherapy

Review Articles

Blood pressure control in hypertensive disorders of pregnancy: Helsi Rismiati, Hae-Young Lee; Cardiovasc Prev Pharmacother. 2022;4(3):99-105. Published online July 29, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e16

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Hypertension is a major cause of maternal morbidity and occurs as a complication in up to one in ten pregnancies. Hypertensive disorders of pregnancy encompass gestational hypertension, preeclampsia, chronic hypertension, and chronic hypertension with superimposed preeclampsia. However, the management of hypertensive disorders of pregnancy remains a matter of debate, particularly the blood pressure thresholds and targets for managing hypertension in pregnancy. Previously, there was no clear evidence of the effectiveness of aggressive blood pressure control in pregnancy due to the risk of fetal growth restriction. Recent clinical trials have shown that aggressive control of blood pressure in pregnant women is safe for both the mother and fetus. The purpose of this paper is to present a clinically oriented guide to the drugs of choice in patients with hypertension during pregnancy, present contrasts among different guidelines and recent clinical trials, and discuss the blood pressure thresholds and targets for hypertension during pregnancy based on recent studies.

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Combined Effects of Methyldopa and Baicalein or Scutellaria baicalensis Roots Extract on Blood Pressure, Heart Rate, and Expression of Inflammatory and Vascular Disease-Related Factors in Spontaneously Hypertensive Pregnant Rats
Michał Szulc, Radosław Kujawski, Przemysław Ł. Mikołajczak, Anna Bogacz, Marlena Wolek, Aleksandra Górska, Kamila Czora-Poczwardowska, Marcin Ożarowski, Agnieszka Gryszczyńska, Justyna Baraniak, Małgorzata Kania-Dobrowolska, Artur Adamczak, Ewa Iwańczyk-S
Pharmaceuticals.2022; 15(11): 1342. CrossRef

Pregnancy at Late Maternal Age and Future Cardiovascular Health: Mi-Jeong Kim; Cardiovasc Prev Pharmacother. 2019;1(2):50-56. Published online October 31, 2019; DOI: https://doi.org/10.36011/cpp.2019.1.e9

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Abstract PDF: Increasing numbers of women are delivering their first child at a later age. First pregnancy at a later age is, per se, a high-risk pregnancy. Pregnancy after 35 years is traditionally considered a late maternal age. The risks of obstetric complications including fetal and maternal complications are increased. Defective placenta syndrome, including hypertensive disorders, preterm birth, and intrauterine growth retardation, shares similar pathophysiologic mechanisms with endothelial dysfunction, although their clinical presentations differ. Recent medical advances have improved the medical performance of pregnancy-related cardiovascular disease (CVD). Recent evidence has shown that women with underlying defective placental syndrome or other pregnancy-related complications have an increased risk of unfavorable cardiovascular outcomes in later life. An increasing number of women delivering their first child at a later age have epidemiological characteristics that differ from those reported previously and for which data are limited data regarding the cardiovascular prognosis. Therefore, increased attention to public health and CVD prevention is required for women with complicated pregnancies.

Original Article

Preterm Labor and Later Maternal Cardiovascular Disease in General Population: Doubtful Relationship with Atherosclerosis: Mi-Jeong Kim, Hae Ok Jung, Sung Ha Chun, Hyeon Woo Yim, Doo Soo Jeon; Cardiovasc Prev Pharmacother. 2019;1(2):71-78. Published online October 31, 2019; DOI: https://doi.org/10.36011/cpp.2019.1.e10

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Abstract PDF: Background
The maternal cardiovascular system experiences an enormous challenge during pregnancy. A history of preterm labor suggestive of dysfunctional pregnancy might be associated with the maternal later life chronic cardiovascular disease (CVD). We evaluated the association between preterm labor and the late development of maternal atherosclerotic CVD using the national database of general population.
Methods
Data for 5,226 postmenopausal women aged ≥50 years were analyzed from the Korean National Health and Nutrition Examination Survey V, which had conducted from 2010 to 2012.
Results
The numbers of preterm labor and CVD (stroke, myocardial infarction, or angina pectoris) were 151 (3.0±0.3%) and 367 (6.6±0.4%), respectively. In a multivariate analysis, CVD was independently associated with age (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.8–2.0), the presence of hypertension (OR, 1.9; 95% CI,1.5–2.3), diabetes (OR, 2.3; 95% CI, 1.8–2.9), chronic kidney disease (OR, 1.8; 95% CI, 1.4–2.2) and low high-density lipoprotein cholesterol concentration (OR, 0.8; 95% CI, 0.7–0.9) were independently associated with CVD. A history of preterm labor was not associated with CVD (OR, 1.5; 95% CI, 0.6–3.8).
Conclusions
There was no significant association between preterm labor and atherosclerotic CVD in general population. A history of preterm labor is not likely to be a risk factor for later CVD in women.

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