Damage from preeclampsia may be seen decades later in the eyes

在怀孕期间患上高血压的女性到中年时眼睛的小血管会出现损伤的迹象, according to new research. The findings suggest small vessel, or microvascular, disease may account for their increased risk of heart disease later in life.

子痫前期——高血压伴有尿中蛋白质过量——发生于 up to 8% of pregnant women. 如果没有适当的处理，它会导致母亲和婴儿的严重并发症.

“越来越多的人认识到，微血管疾病是中年和老年人群心血管疾病的一个重要潜在因素," said the study's lead author Dr. 波士顿麻省总医院的心脏病专家Michael Honigberg说. "And so one might reasonably ask, 如果一个女人在怀孕的早期有某种微血管并发症, 这个女人在她的微血管功能和以后的健康方面有什么不正常吗?"

研究人员使用了19,000多名平均年龄为54岁的白人女性的数据. They had given birth for the first time an average of 28 years before. They had different scans and tests between 2006 and 2010, including images of their retinas and urine tests. 其中，281名怀孕期间有高血压的妇女与没有高血压的妇女进行了比较. The findings 周一发表在美国心脏协会的期刊《线上电子游戏飞禽走兽》上.

有先兆子痫病史的女性尿液中的蛋白质含量仍然增加, a sign of kidney damage. 他们眼睛里的小血管密度也要低得多 2021 study in Circulation linked to conditions such as high blood pressure, heart failure, kidney failure, Type 2 diabetes and sleep apnea.

这表明视网膜的照片——可以非侵入性地拍摄——可能是预测许多疾病风险的有用工具.

“直接观察心脏微血管疾病是具有挑战性的，因为你需要做更多复杂的心脏测试," said the study's senior author Dr. 马萨诸塞州总医院预防心脏病学主任Pradeep Natarajan说. “因此，我们有能力通过另一个血管化的器官以低成本观察微血管的变化. Further understanding may help develop new therapies to address this process."

For now, Honigberg said, 这些发现可以帮助妇女和她们的医生认识到子痫前期患者的长期过度风险，并采取已知的降低心脏病风险的措施, such as lifestyle changes and medications to treat risk factors.

研究人员对当前血压和其他因素进行调整后，研究中患有妊娠期高血压(妊娠期没有其他症状的高血压)的妇女的眼部血管密度没有变化.

“他们已经表明，视网膜血管密度降低是子痫前期特有的，”Dr. Vesna Garovic, 罗切斯特市梅奥诊所肾脏病和高血压科主任, Minnesota, who was not involved in the study. "Therefore, 本研究对妊娠期不同高血压疾病的分层及其对心血管疾病的特异性影响具有重要意义."

Because the study included mostly white women, 研究人员表示，目前还不清楚这些发现在多大程度上适用于其他种族和民族. Black women, previous research shows, are the most likely to develop preeclampsia.

需要更多的研究来更好地了解微血管变化的线上电子游戏飞禽走兽与子痫前期和后来的心脏病有关, 并确认使用视网膜图像预测心血管风险的有效性, said Garovic, who led the writing of an AHA scientific statement about hypertension in pregnancy published in December.

It might turn out, Garovic said, that just as the eyes have been called the window to the soul, the eyes also "are the windows to cardiovascular health."

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