Antenatal Programming of Hypertension: Paradigms, Paradoxes, and How We Move Forward.

IF 3.9 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Current Hypertension Reports Pub Date : 2022-12-01 Epub Date: 2022-10-13 DOI:10.1007/s11906-022-01227-z
Andrew M South, Norrina B Allen
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引用次数: 1

Abstract

Purpose of review: Synthesize the clinical, epidemiological, and preclinical evidence for antenatal programming of hypertension and critically appraise paradigms and paradoxes to improve translation.

Recent findings: Clinical and epidemiological studies persistently demonstrate that antenatal factors contribute to programmed hypertension under the developmental origins of health and disease framework, including lower birth weight, preterm birth, and fetal growth restriction. Preclinical mechanisms include preeclampsia, maternal diabetes, maternal undernutrition, and antenatal corticosteroid exposure. However, clinical and epidemiological studies to date have largely failed to adequately identify, discuss, and mitigate many sources and types of bias in part due to heterogeneous study designs and incomplete adherence to scientific rigor. These limitations have led to incomplete and biased paradigms as well as persistent paradoxes that have significantly limited translation into clinical and population health interventions. Improved understanding of these paradigms and paradoxes will allow us to substantially move the field forward.

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高血压产前规划:范式,悖论,以及我们如何前进。
综述的目的:综合高血压产前规划的临床、流行病学和临床前证据,批判性地评估范式和悖论,以改进翻译。最新发现:临床和流行病学研究持续表明,在健康和疾病框架的发育起源下,产前因素有助于程序性高血压,包括低出生体重、早产和胎儿生长受限。临床前机制包括先兆子痫、母体糖尿病、母体营养不良和产前皮质类固醇暴露。然而,迄今为止的临床和流行病学研究在很大程度上未能充分识别、讨论和减轻许多偏倚的来源和类型,部分原因是异质性研究设计和不完全遵守科学严谨性。这些限制导致了不完整和有偏见的范例以及持续存在的悖论,大大限制了将其转化为临床和人口健康干预措施。改善对这些范例和悖论的理解将使我们实质性地推动该领域向前发展。
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来源期刊
Current Hypertension Reports
Current Hypertension Reports 医学-外周血管病
CiteScore
10.50
自引率
0.00%
发文量
65
审稿时长
6-12 weeks
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hypertension. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antihypertensive therapies, associated metabolic disorders, and therapeutic trials. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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