4CPS-201 Risk of cardiovascular events during pregnancy: a prospective observational study

Background

Cardiovascular diseases (CVD) are among the most significant causes of quality of life deterioration. Females experiencing medical conditions such as hypertension and diabetes mellitus (DM) are at increased risk of future CVD. Studies have reported the association of pregnancy-related medical conditions with a long-term increase in cardiovascular risks such as hyperlipidaemia, vascular dysfunction, insulin resistance and DM.

Purpose

To investigate the possible risk of the occurrence of cardiovascular events among pregnant females.

Material and methods

A prospective observational study conducted on 92 pregnant females at different gestational periods admitted at a gynaecological clinic in Baghdad Governorate between February and May 2017. Records of the demographic and gestational data for each patient were gathered. Health records regarding cardiovascular risk assessment were also collected by the clinical pharmacist.

Results

The mean age was 28.26±6.2 years. Sixty percent of patients were suffering from concomitant hypertension with DM, 39% of patients were using low-dose aspirin tablets and 50% were using methyldopa tablets. Participants with pregnancy-related medical conditions showed an increase in systolic blood pressure (SBP) (p=0.0001) compared to normal. There was a significant increase in SBP 125 mmHg at a gestational age (25–37 weeks) compared to 111.33 mmHg for those at (1–13 weeks) (p=0.051). We observed a significant correlation between Framingham Risk Score and patients with hypertension alone (p=0.0284); patients with DM alone (p=0.008); and patients having concomitant hypertension with DM (p=0.0001). Half of the patients suffering from concomitant hypertension with DM were at Framingham Risk of 1%, while 10% of patients were at 3%.

Conclusion

Pregnant females with medical conditions such as hypertension and DM have abnormal cardiovascular panels that burden them for further long-term CVD risk. Framingham Risk was low in the majority of patients due to lower age of the participants, and usage of antihypertensive medications and DM therapeutic medications. These results spotlight more pharmacy care by the clinical pharmacist during the gestational period.

References and/or Acknowledgements

1. Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet2009;373:1773–1779. 2. Shah BR, Retnakaran R, Booth GL. Increased risk of cardiovascular disease in young women following gestational diabetes mellitus. Diabetes Care2008;31:1668–1669. No conflict of interest