According to studies conducted by British and Norwegian researchers, women with cardiovascular risk factors are at increased risk of developing preeclampsia during pregnancy, and pregnant women who do develop preeclampsia are at higher risk for developing heart disease later in life. Preeclampsia, a condition in which abnormally high blood pressure develops during the second half of pregnancy, affects about 5 percent of all first pregnancies and presents serious risks to both mother and child. The findings of these studies are published in the November 2, 2007 online edition of the British Medical Journal.
In the first study, Norwegian researchers found that cardiovascular risk factors that are present prior to pregnancy increase the risk of developing preeclampsia sevenfold. "This study is the first that confirms the hypothesis that lipid and blood pressure abnormalities before pregnancy are strong predictors of preeclampsia," said lead author Elisabeth Balstad Magnussen, a researcher in the Department of Public Health Faculty of Medicine, Norwegian University of Science and Technology, Trondheim.
In assessing the risk of developing preeclampsia, the researchers evaluated nearly 3500 women and documented relevant cardiovascular risk factors, including blood pressure, cholesterol, blood sugar levels, weight and body mass index, prior to pregnancy. The researchers discovered the following: (1) 133 members of the group developed preeclampsia during pregnancy; (2) women with high blood pressure, high cholesterol and high blood sugar levels before pregnancy were seven times more likely to develop preeclampsia as compared with the others; (3) women with a family history of high blood pressure, heart disease, or diabetes had double the risk of developing preeclampsia; (4) women who were overweight or obese faced an increased risk of developing preeclampsia; and (5) women who had used oral contraceptives had half the risk of preeclampsia as compared with those who never used oral contraceptives.
"The findings suggest that preeclampsia and cardiovascular diseases may share a common origin, and that the increased risk of cardiovascular disease subsequent to preeclampsia, at least partly, is due to an underlying biological trait of the woman," Magnussen said.
In the second study, British researchers reviewed 25 studies that included 3.5 million women worldwide and found that nearly 200,000 had developed preeclampsia while pregnant. The researchers then projected the future risk of heart disease, stroke, hypertension and thromboembolism. "Women who have had preeclampsia are at a roughly twofold increased risk of cardiovascular disease in later life, compared with women who did not have preeclampsia," said David Williams, lead researcher and a consultant obstetric physician at the Institute for Women’s Health at Elizabeth Garrett Anderson Obstetric Hospital, University College London. "Specifically, these women have an almost fourfold increased risk of hypertension, and a doubling of the risk of heart disease, stroke, and venous thromboembolism," he added. Further, according to Williams, some of the more extensive studies in the review suggested that the increased risk of heart disease after preeclampsia is independent of other known risk factors and, thus, should become an important factor when assessing a woman’s cardiovascular risk.
According to Dr. Richard Levine, a senior investigator at the National Institute of Child Health and Human Development in the United States, women who develop preeclampsia should be screened for heart disease, diabetes and metabolic syndrome, and women at risk for preeclampsia before becoming pregnant should also try to reduce their cardiovascular risk factors to help prevent the condition.
For important information about preeclampsia, please see The Preeclampsia Foundation.
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