Women who have had preeclampsia are at increased risk of cardiovascular disease later in life, suggesting that they should be targeted for primary prevention, according to a British review.
“The underlying link between pre-eclampsia and cardiovascular disease is unclear. Although pre-eclampsia may initiate endothelial damage, it is thought to be more likely that pre-eclampsia and cardiovascular disease have a common pathogenesis rooted in shared risk markers,” wrote Dr. Laura Magee and Dr. Peter von Dadelszen of the University of British Columbia, Vancouver, in a commentary (BMJ 2007 Nov. 2 [Epub doi.10.113/bmj.39337.427500.80]).
In a review of cohort studies in all languages between 1960 and 2006 covering more than 3 million women, British researchers found an increased risk for vascular disease among women who'd had preeclampsia, compared with those who never had the disorder. The relative risks for women with a history of preeclampsia were 3.7 for hypertension after a mean weighted follow-up of 14 years, 2.2 for ischemic heart disease after 12 years, 1.8 for stroke after 10 years, 1.8 for venous thromboembolism after almost 5 years, wrote Leanne Bellamy, a medical student at Imperial College School of Medicine, London, and her associates (BMJ 2007 Nov. 2 [Epub doi:10.1136/bmj.39335.385301.BE]).
The overall risk of mortality was elevated following preeclampsia, with a relative risk of 1.49 after 14.5 years.
“We must recognise that these women are still young, their absolute risk of cardiovascular disease is low over the short term, and their risk will evolve over subsequent decades,” wrote Dr. Magee and Dr. von Dadelszen in their commentary. “As such, we have an opportunity for primary prevention.”