Documento de consenso de la SEGO y el CEIPV. Ventana de oportunidad: prevención del riesgo vascular en la mujer. Resultados adversos del embarazo y riesgo de enfermedad vascular
e202310084
Palabras clave:
Riesgo vascular, Embarazo, Postparto, Prevención de riesgoResumen
Este documento resume la evidencia que existe entre los resultados adversos del embarazo (RAE), tales como son los trastornos hipertensivos, el parto pretérmino, la diabetes gestacional, los defectos en el crecimiento fetal (feto pequeño para la edad gestacional y/o restricción del crecimiento), el desprendimiento de placenta y la pérdida fetal, y el riesgo que tiene una persona gestante de desarrollar factores de riesgo vascular (RV) que pueden terminar provocando enfermedad vascular (EV) futura: cardiopatía coronaria, accidente cerebrovascular, enfermedad vascular periférica e insuficiencia cardíaca. Asimismo, este documento destaca la importancia de saber reconocer los RAE cuando se evalúa el RV en mujeres. Un antecedente de RAE es un indicador suficiente para hacer una prevención primaria de EV. De hecho, adoptar una dieta saludable y aumentar la actividad física entre las mujeres con RAE, de inicio en el embarazo y/o postparto y manteniéndolo a lo largo de la vida, son intervenciones importantes que permiten disminuir el RV. Por otro lado, la lactancia materna también puede disminuir el RV posterior de la mujer, incluyendo menos riesgo de mortalidad.
Estudios futuros que evalúen el uso del ácido acetilsalicílico, las estatinas y la metformina, entre otros, en las mujeres con antecedentes de RAE podrían reforzar las recomendaciones sobre el uso de la farmacoterapia en la prevención primaria de la EV entre estas pacientes. Existen diferentes opciones dentro de los sistemas de salud para mejorar la transición de la atención de las mujeres con RAE entre los diferentes profesionales e implementar estrategias para reducir su RV a largo plazo. Una posible estrategia podría ser la incorporación del concepto del cuarto trimestre en las recomendaciones clínicas y las políticas de atención de la salud.
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Derechos de autor 2023 María Goya, Marta Miserachs, Anna Suy Franch, Jorge Burgos, María de la Calle, Carlos Brotons, Mar Castellanos, Olga Cortés Rico, Ángel Díaz Rodriguez, Roberto Elosúa, María del Mar Freijo, María González Fondado, Manuel Gorostidi, María Grau, Antonio M. Hernández Martínez, Carlos Lahoz, Nuria Muñoz-Rivas, Vicente Pallares-Carratalá, Juan Pedro-Botet, Enrique Rodilla, Miguel Ángel Royo Bordonada, Rafael Santamaría, Mónica Torres Fonseca, Aina Velescu, Alberto Zamora, Pedro Armario
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