Hypertensive disorders of pregnancy (HDP) are associated with significantly increased risk of developing future cardiovascular disease (CVD). Obstetricians play a crucial role in CVD prevention for postpartum women and birthing people with HDP because they are primarily responsible for immediate postpartum management and can assist with care transitions to other health care practitioners for long-term management of CVD risk factors. Standardized calculators can be used to evaluate long-term CVD risk, which can help guide intensity of treatment. Emerging technologies such as remote blood pressure monitoring demonstrate promise for improving outcomes among patients with HDP. After HDP, all patients should be advised of their increased CVD risk. A plan should be made to initiate lifestyle modifications and antihypertensive therapy to achieve optimal blood pressure control with a target of lower than 130/80 mm Hg, assess lipids within 2-3 years of delivery, and evaluate for development of type 2 diabetes. Other CVD risk factors such as nicotine use should similarly be identified and addressed. In this review, we summarize the essential components of managing CVD risk after a pregnancy complicated by HDP, including blood pressure monitoring, risk stratification tools, and evidence-based lifestyle recommendations.

中文翻译：

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妊娠期高血压疾病后的心血管危险因素管理。


妊娠期高血压疾病 (HDP) 与未来患心血管疾病 (CVD) 的风险显着增加相关。产科医生在产后妇女和患有 HDP 的分娩者的 CVD 预防中发挥着至关重要的作用，因为他们主要负责产后的立即管理，并可以协助将护理过渡到其他医疗保健从业者，以长期管理 CVD 危险因素。标准化计算器可用于评估长期 CVD 风险，这有助于指导治疗强度。远程血压监测等新兴技术有望改善 HDP 患者的预后。 HDP 后，应告知所有患者 CVD 风险增加。应制定计划开始生活方式改变和抗高血压治疗，以实现最佳血压控制，目标为低于 130/80 mm Hg，在分娩后 2-3 年内评估血脂，并评估 2 型糖尿病的发生情况。其他 CVD 风险因素，例如尼古丁的使用，也应同样予以识别和解决。在这篇综述中，我们总结了妊娠并发 HDP 后管理 CVD 风险的基本组成部分，包括血压监测、风险分层工具和基于证据的生活方式建议。