ROLE OF RISK FACTORS FOR ARTERIAL HYPERTENSION IN PREGNANT WOMEN

Aim. To assess risk factors for arterial hypertension in pregnant women.

Methods. The prevalence of risk factors for arterial hypertension (AH) was estimated in 240 pregnant women with arterial hypertension (AH) and 126 healthy pregnant women. Women with symptomatic or gestational hypertension or diabetes mellitus were excluded from the study. The following AH risk factors were assessed: age, family history, smoking, overweight/obesity, and excessive salt intake. Odds ratios were calculated utilizing stepwise logistic regression.

Results. Pregnant women ≥32 years of age had 1.33-fold higher risk of AH in comparison with those <32 years of age. Hypertensive status of both parents or one of them was associated with 1.8- and 1.67-fold higher risk of AH as compared to patients without family history of AH. Smoking, overweight, and obesity increased risk of AH by a factor of 1.83, 1.74, and 2.24, respectively. Combination of age ≥32 years with obesity, family history of AH or smoking status further augmented risk of AH (2.46-, 2.18 or 2.14-fold, respectively) as compared to healthy pregnant women. Likewise, combination of AH family history with overweight or obesity resulted in 2.9- and 3.0-fold higher risk of AH. Combination of smoking with family history of AH, overweight, and obesity increased risk of AH by a factor of 2.95, 3.61, and 4.65, respectively. Amount of salt intake did not differ in pregnant women with and without AH.

Conclusion. The estimated risk factors for AH are significant in pregnant women. Age over 32 years was associated with 1.33 OR for AH, family history with 1.8 OR, smoking with 1.83 OR, overweight with 1.7 OR, whereas obesity increased 2.24-fold odds for AH. Obesity and family history increased 2.9-fold odds for AH, whereas smoking and family history were associated with 3-fold increased odds for AH and combined with obesity up to 4.6-fold increased odds. 

1. Chazova I.E.1, Zhernakova Yu. V.1, Oshchepkova E.V.1, Shalnova S.A., Yarovaya E.B., Konradi A.O. et al. Prevalence of Cardiovascular Risk Factors in Russian Population of Patients With Arterial Hypertension. Kardiologiia. +2014; 54 (10): 4 – 12. (In Russian).

2. Diagnostika i lechenie arterial'noj gipertonii u beremennyh. Pod red. G.T. Suhih, O.N. Tkachevoj. Moscow; 2011. 102 p. (In Russian).

3. Adamyan L.V., Artymuk N.V., Bashmakova N.V., Belokrinnickaya T.E., Belomestnov S.R., Bratishchev I.V. et al. Hypertensive disturbances during pregnancy, in parturition and postpartum period: Clinical recommendations (Proceedings of treatment). Moscow; 2016. 72 p. (In Russian).

4. Stryuk R.I., Bunin YU.A., Gur'eva V.M., Irtyuga O.B., Kokov L.S., Kolomackaya O.E. Diagnosis and treatment of cardiovascular diseases during pregnancy 2018. National guidelines. Russian Journal of Cardiology. 2018;(3):91-134. (In Russian) https://doi.org/10.15829/1560-4071-2018-3-91-134

5. Shekhtman M.M. Rukovodstvo po ehkstragenital'noj patologii u beremennyh. Moscow: Triada-H; 1999. 814 p. (In Russian)

6. Galie N., Humbert M., Vachiery J.L., Gibbs S., Lang I., Torbicki A. et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). EurRespir J. 2015; 46 (4): 903-75. DOI: 10.1183/13993003.01032-2015

7. Mugo M., Govindarajan G., Kurukulasuriya L.R., Sowers J.R., McFarlane S. Hypertension in pregnancy. Curr. Hypertens. Rep. 2005; 7 (5): 348-354.

8. Kobalava ZH.D., Kotovskaya YU.V., Moiseev V.S. Arterial'naya gipertoniya. Klyuchi k diagnostike i lecheniyu. Moscow: GEHOTAR-Media; 2009. 864 p. (In Russian)

9. Kaplan N.M. Obesty in hypertension: effects on prognosis and treatment. J. Hypertens. 1998; 16 (suppl 1): 35 – 37.

10. Brytkova Ya.V., Stryuk R.I. The Course of Pregnancy in Women with Arterial Hypertension. Kardiologiia 2017; 1: 65 – 70. (In Russ.) DOI: 10.18565/cardio.2017.1.65-70

11. Levakov S.F., Borovkova E.I., Pregnancy with obesity and metabolic syndrome. Question of gynecology, obstetrics and perinalogy. 2014; 13 ( 5): 5 – 10. (In Russian)

12. Suhih G.T., Krasnopol`skij V.I., Runihina N.K., Tkacheva O.N., Khodzhaeva Z.S., Petrukhin V.A. et al. The transition to a new level of administration of hypertensive and metabolic complication during pregnancy: current diagnostic for gestational diabetes. Obstetrics and Gynicolodgy. 2013; 3: 4-9. (In Russian)

13. Radzinskij V.E. i dr. Pregravidarnaya podgotovka: klinicheskij protokol. Moscow: StatusPresent; 2016. 80 c. (In Russian)

14. Stryuk R.I., Berns S.A., M. P. Fillipova Ya.V., Brytkova Ya.V., Borisov I.V., Barkova E.L. et al. Cardiovascular disease and associated comorbid conditions as determinants of adverse perinatal outcomes in pregnancy — an analysis of the results of the register of pregnant BEREG. Terapevticheskij arkhiv 2018; 90 (1): 9-16. (In Russian) DOI: 10.17116/terarkh20189019-16