Rise in cardiovascular issues in women after preeclampsia

on 28 February 2018 Cardiovascular Pregnancy

Women diagnosed with preeclampsia during pregnancy were significantly more likely to develop high blood pressure, diabetes or high cholesterol within five years compared with women who did not have preeclampsia, a US study has found.

Previous studies have found women who had preeclampsia during pregnancy face a substantially higher risk of coronary heart disease, stroke and heart failure later in life. 

The findings from the new study, presented at the American College of Cardiology's 67th Annual Scientific Session, indicate signs of heart disease risk can often emerge in the first few years after a woman experiences preeclampsia. 

The study's lead author and cardiology fellow at Allegheny Health Network Karlee Hoffman said: ‘Women are highly motivated to take care of themselves when they are pregnant and after they deliver their babies, so it's a great time to educate them on long-term cardiovascular risks and potentially intervene with aggressive lifestyle modification.’

Researchers analyzed the health records of more than 650 women treated between 2009 and 2015. 

Half had been diagnosed with preeclampsia and half were women of a similar age and racial makeup who had never had a preeclampsia diagnosis (controls). 

Five years of follow-up health information was available for just over 250 of the women diagnosed with preeclampsia.

Around the time of their birth, those with preeclampsia had a higher rate of obesity, preterm birth, babies with low birthweight and post-birth complications. 

Over the following five years, those with preeclampsia were more likely to develop high blood pressure (which occurred in 32.8% of women with preeclampsia and 0.3% of controls), new-onset diabetes (which occurred in 21% of women with preeclampsia and zero among controls) and high cholesterol (which occurred in 3% of women with preeclampsia and zero among controls).

Of those who had follow-up with a primary care physician after a diagnosis of preeclampsia, only one patient's chart noted the doctor was aware of the preeclampsia diagnosis and mentioned long-term follow-up with regard to cardiovascular disease.

According to the research, although the exact causes are unknown, it is thought that oxidative stress, which results from having too much of the unstable form of oxygen in the body, could play a role in the cardiovascular effects seen after preeclampsia. 
Oxidative stress has been linked with the physiological changes that contribute to coronary artery disease. 

To further elucidate the connections between preeclampsia and heart disease, researchers are planning a study that will use echocardiography and noninvasive pulse wave velocity to investigate heart health after preeclampsia.