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Open Access Study protocol

10-Year cardiovascular event risks for women who experienced hypertensive disorders in late pregnancy: the HyRAS study

Wietske Hermes12*, Arie Franx3, Maria G van Pampus4, Kitty W Bloemenkamp2, Joris A van der Post5, Martina Porath6, Gabrielle Ponjee7, Jouke T Tamsma8, Ben W Mol5 and Christianne J de Groot1

Author affiliations

1 Department of Obstetrics and Gynecology, Medical Centre Haaglanden Den Haag, the Netherlands

2 Department of Obstetrics and Gynecology, Leiden University Medical Centre, the Netherlands

3 Department of Obstetrics and Gynecology, Sint Elisabeth Hospital Tilburg, the Netherlands

4 Department of Obstetrics and Gynecology, University Medical Centre Groningen, the Netherlands

5 Department of Obstetrics and Gynecology, Academic Medical Centre Amsterdam, the Netherlands

6 Department of Obstetrics and Gynecology, Maxima Medical Centre Veldhoven, the Netherlands

7 Department of Clinical Laboratory, Medical Centre Haaglanden Den Haag, the Netherlands

8 Department of Internal Medicine, Leiden University Medical Centre, the Netherlands

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Citation and License

BMC Pregnancy and Childbirth 2010, 10:28  doi:10.1186/1471-2393-10-28

Published: 1 June 2010

Abstract

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/Design

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.

Discussion

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.

Trial registration

The HYPITAT trial is registered in the clinical trial register as ISRCTN08132825.