背景:先兆子痫和妊娠期高血压后心血管疾病的终生风险已得到确认。然而,目前尚不清楚这些证据是否已转化为临床实践指南.因此,本综述旨在评估澳大利亚临床实践指南关于妊娠期高血压和先兆子痫后心血管疾病风险的质量和内容.
方法:我们对MEDLINE(Ovid)进行了系统搜索,EMBASE(Ovid),和CINAHL数据库,还有医院,产科协会,还有医学院的网站.包括以下情况的出版物:它们是临床实践指南;在过去十年中发表;并包括对妊娠高血压疾病后未来心血管疾病风险管理的建议。质量评估采用《研究和评估仪器评估指南》第2版(AGREE-II)和《AGREE推荐卓越仪器》(AGREE-REX)进行。
结果:确定了18个指南,其中,不到一半(n=8)纳入了妊娠期高血压疾病后未来心血管风险管理建议.在这八个人中,在以下方面发现了四项主要咨询建议:(1)未来心血管疾病的风险;(2)危险因素筛查;(3)生活方式干预;(4)未来妊娠的产前咨询.这些建议的质量和内容差异很大,大多数指南(87.5%)被评估为中低质量.
结论:澳大利亚关于妊娠期高血压疾病后心血管疾病未来风险的临床实践指南有限。这些指南的质量和内容差异很大。这些发现强调了从循证研究中改进翻译的必要性,以加强临床护理和指导。
The lifelong risks of cardiovascular disease following preeclampsia and gestational hypertension are well-established. However, it is unclear whether this evidence has been translated into clinical practice
guidelines. Thus, this review aimed to assess the quality and content of Australian clinical practice
guidelines regarding the risk of cardiovascular disease following gestational hypertension and preeclampsia.
We conducted a systematic search of MEDLINE (Ovid), EMBASE (Ovid), and CINAHL databases, as well as hospital, obstetric society, and medical college websites. Publications were included if: they were a clinical practice
guideline; were published in the previous ten years; and included recommendations for the management of future cardiovascular disease risk following hypertensive disorders of pregnancy. Quality assessment was performed using Appraisal of
Guidelines for Research and Evaluation Instrument Version Two (AGREE-II) and AGREE Recommendations Excellence Instrument (AGREE-REX).
Eighteen guidelines were identified, and of these, less than half (n = 8) included recommendations for managing future cardiovascular risk following hypertensive disorders of pregnancy. Across these eight, four main counselling recommendations were found regarding (1) risk of future cardiovascular disease; (2) risk factor screening; (3) lifestyle interventions; and (4) prenatal counselling for future pregnancies. The quality and content of these recommendations varied significantly, and the majority of guidelines (87.5%) were assessed as low to moderate quality.
There are limited Australian clinical practice guidelines providing appropriate advice regarding future risk of cardiovascular disease following hypertensive disorders of pregnancy. The quality and content of these
guidelines varied significantly. These findings highlight the need for improved translation from evidence-based research to enhance clinical care and guidance.