Background
Peripheral vascular disease (PVD) includes peripheral arterial disease (PAD) and venous disease. PAD affects nearly 200 million people globally, and this number is expected to rise due to population ageing. Venous disease is also significant cause of morbidity globally. The American Heart Association has highlighted the rising prevalence of PVD among women, emphasizing the importance of sex-specific preventive measures.
Hypertensive disorders of pregnancy (HDP) are among the most common pregnancy complications globally (e.g. preeclampsia, gestational hypertension). It is increasingly acknowledged that HDP are associated with the long-term risk of cardiac disease, renal disease, and stroke in later life, and that obstetric factors may offer insights for sex-specific preventive interventions. However, the risk that HDP may present to the peripheral vascular system among parous women is less understood.
Aims
The aim of this proposed systematic review and meta-analysis is to synthesize the available literature on the association between HDP and the long- term risk of PVD in women.
Objectives
To summarise existing evidence on the associations between HDP and subsequent risk of PVD in parous women.
To conduct a meta-analysis of effect estimates of the association between HDP and PVD
To consider whether women who experience HDP may benefit from follow-up interventions to reduce their long-term risk of PVD.
Hypothesis
Women exposed to HDP are at increased long-term risk of PVD.
Methods
PECO (Population, Exposure, Comparison, Outcome)
P: Women who have had at least one pregnancy
E: Diagnosis of any HDP
C: Women with normotensive pregnancy
O: Primary outcome: Any PVD diagnosed >6 months after pregnancy. Secondary outcomes: i) PAD ii) Venous thromboembolism iii) other peripheral vascular disease.
This study may help to inform risk prevention strategies by examining a range of associations between different types of HDP and PVD among parous women in later life.