Postpartum low-dose aspirin to augment vascular recovery following a hypertensive disorder of pregnancy

产后小剂量阿司匹林可促进妊娠高血压疾病后的血管恢复

• 批准号: 10644089
• 负责人: Alisse Hauspurg
• 金额: $ 16.74万
• 依托单位: MAGEE-WOMEN'S RES INST AND FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-07 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10644089
• 关键词: Adult; Antihypertensive Agents; Antiinflammatory Effect; Aspirin; Attention; Award; Blood Pressure; Blood Vessels; Breast Feeding; Cardiovascular Diseases; Cardiovascular system; Career Mobility; Caring; Cause of Death; Chronic; Clinical; Clinical Trials; Data; Diagnosis; Disparity; Dose; Eligibility Determination; Endothelium; Enrollment; Evaluation; Evidence based intervention; Female of child bearing age; Funding; Future; Goals; Health; Home; Hypertension; Individual; Intention; Intervention; Iontophoresis; Leadership; Link; Maternal Mortality; Measures; Mentored Clinical Scientist Development Program; Mentored Patient-Oriented Research Career Development Award; Mentors; Mission; Monitor; Morbidity - disease rate; Pathway interactions; Pharmaceutical Preparations; Phenotype; Placebos; Population; Postpartum Hypertension; Postpartum Period; Pre-Eclampsia; Pregnancy; Prevention; Primary Prevention; Public Health; Randomized; Randomized, Controlled Trials; Recommendation; Recovery; Research; Research Personnel; Risk; Risk Reduction; Role; Sample Size; Site; Standardization; Testing; Therapeutic Agents; Time; Translational Research; United States National Institutes of Health; Vascular Diseases; Vasodilation; Woman; Work; age group; antenatal; blood pressure control; blood pressure reduction; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; career; design; disability; disparities in morbidity; disparity reduction; effective intervention; evidence base; experience; feasibility testing; health care disparity; hypertension control; improved; innovation; intrapartum; maternal morbidity; mortality; novel; novel strategies; pathophysiology of preeclampsia; patient population; pharmacologic; pilot test; pilot trial; post intervention; pregnancy disorder; pregnancy health; prevent; randomized trial; skill acquisition; success; systemic inflammatory response; therapy development; treatment as usual; treatment duration; treatment strategy; young woman; Adult; Antihypertensive Agents; Antiinflammatory Effect; Aspirin; Attention; Award; Blood Pressure; Blood Vessels; Breast Feeding; Cardiovascular Diseases; Cardiovascular system; Career Mobility; Caring; Cause of Death; Chronic; Clinical; Clinical Trials; Data; Diagnosis; Disparity; Dose; Eligibility Determination; Endothelium; Enrollment; Evaluation; Evidence based intervention; Female of child bearing age; Funding; Future; Goals; Health; Home; Hypertension; Individual; Intention; Intervention; Iontophoresis; Leadership; Link; Maternal Mortality; Measures; Mentored Clinical Scientist Development Program; Mentored Patient-Oriented Research Career Development Award; Mentors; Mission; Monitor; Morbidity - disease rate; Pathway interactions; Pharmaceutical Preparations; Phenotype; Placebos; Population; Postpartum Hypertension; Postpartum Period; Pre-Eclampsia; Pregnancy; Prevention; Primary Prevention; Public Health; Randomized; Randomized, Controlled Trials; Recommendation; Recovery; Research; Research Personnel; Risk; Risk Reduction; Role; Sample Size; Site; Standardization; Testing; Therapeutic Agents; Time; Translational Research; United States National Institutes of Health; Vascular Diseases; Vasodilation; Woman; Work; age group; antenatal; blood pressure control; blood pressure reduction; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; career; design; disability; disparities in morbidity; disparity reduction; effective intervention; evidence base; experience; feasibility testing; health care disparity; hypertension control; improved; innovation; intrapartum; maternal morbidity; mortality; novel; novel strategies; pathophysiology of preeclampsia; patient population; pharmacologic; pilot test; pilot trial; post intervention; pregnancy disorder; pregnancy health; prevent; randomized trial; skill acquisition; success; systemic inflammatory response; therapy development; treatment as usual; treatment duration; treatment strategy; young woman

PROJECT ABSTRACT Cardiovascular disease (CVD) is the leading cause of death in women worldwide and despite declines in all other age groups, mortality rates attributed to CVD are increasing in women of childbearing age. Preeclampsia is a well-established risk factor for CVD across diverse patient populations, however, there are currently no evidence-based interventions targeting this at-risk patient population. While blood pressure control is the cornerstone of postpartum management, emerging evidence suggests that management of hypertension alone does not fully mitigate CVD risk after preeclampsia. The overall goal of this line of research is to begin to develop and test novel pharmacologic interventions for postpartum management following preeclampsia, representing a paradigm shift focused on endothelial recovery postpartum in addition to blood pressure control. In this application, the objective is to conduct a single-site pilot trial to assess the feasibility and effect of low- dose aspirin to augment vascular recovery in the immediate postpartum period after preeclampsia through two specific aims: to pilot test the feasibility of conducting a randomized controlled trial of postpartum low-dose aspirin vs. placebo, and 2) to assess the effect of postpartum aspirin on endothelial function and blood pressure. Our central hypothesis is that postpartum administration of low-dose aspirin following preeclampsia will be feasible, improve endothelial function, and lower BP at 6 months postpartum. The research proposed in this application is innovative in its novel adaptation of an evidence-based strategy to improve vascular function and postpartum blood pressure in an understudied population with significant morbidity during a critical time period. This proposal is significant as it will provide an opportunity to assess the feasibility and explore the effect of low-dose aspirin on vascular function in addition to blood pressure. Effective interventions to improve postpartum hypertension care and reduce long-term cardiovascular risk have broad implications for improving maternal morbidity and reducing disparities in care. Our findings will provide a valuable framework to inform a subsequent large-scale randomized trial of low-dose aspirin in the postpartum period following preeclampsia. Successful completion of this line of research would represent a transformation in postpartum management of women with hypertensive disorders of pregnancy and have a direct impact to improve hypertension and cardiovascular-related maternal morbidity and mortality.

项目摘要 心血管疾病（CVD）是全球女性死亡的主要原因，尽管所有人都在下降 其他年龄段，育儿妇女归因于CVD的死亡率正在增加。子痫前期 是各种患者人群中CVD的公认风险因素，但是目前没有 针对这种高危患者人群的循证干预措施。而血压控制是 产后管理的基石，新兴的证据表明，仅对高血压管理 先兆子痫之后不会完全减轻CVD风险。这一研究的总体目标是开始 开发和测试新颖的药理学干预措施，用于产后治疗后的产后管理 除了血压控制外，代表范式转移的范式侧重于内皮恢复产后。 在此应用中，目的是进行单点试验试验，以评估低 - 的可行性和影响 剂量阿司匹林可在先前的产后立即增加血管恢复。 具体目的：试点测试进行产后低剂量随机对照试验的可行性 阿司匹林与安慰剂，以及2）评估产后阿司匹林对内皮功能和血液的影响 压力。我们的中心假设是，先前子宫症后，产后给予低剂量阿司匹林 将是可行的，改善内皮功能，并在产后6个月下降低BP。该研究提出了 该应用在其新颖的改编基于证据的策略以改善血管功能方面具有创新性 和在关键时期内发病率明显的研究的研究中的产后血压 时期。该提案很重要，因为它将提供一个评估可行性并探索的机会 除血压外，低剂量阿司匹林对血管功能的影响。有效改善的干预措施 产后高血压护理并减少长期心血管风险，对改善有广泛的影响 孕产妇的发病率和减少护理差异。我们的发现将提供一个宝贵的框架，以告知 先兆子痫后，在产后时期，低剂量阿司匹林的随后大规模随机试验。 成功完成这项研究将代表产后管理的转变 患有高血压疾病的妇女，对改善高血压和 心血管相关的孕产妇发病率和死亡率。