Preeclampsia Linked to Earlier Development of Cardiovascular Risk Factors

Recent research presented at the European Society of Cardiology (ESC) Preventive Cardiology congress highlights a concerning trend among women who have experienced preeclampsia. These women tend to accumulate cardiovascular (CV) risk factors at a significantly accelerated rate compared to those who have had pregnancies without this condition.

Preeclampsia, affecting approximately 2-5% of pregnant women, is characterized by the sudden onset of hypertension and elevated protein levels in the urine of women with previously normal blood pressure. Beyond the immediate health risks associated with preeclampsia for both mother and child, studies indicate that women with a history of this condition face a double risk of developing cardiovascular diseases (CVD) and strokes later in life.

Despite the known long-term health implications, current medical guidelines do not provide specific recommendations regarding the need for systematic cardiovascular assessments for these women. This gap is largely attributed to a lack of empirical evidence, according to a study led by a team from Maastricht University Medical Center in the Netherlands.

The study, part of the Queen of Hearts project, aims to explore the prevalence of cardiovascular risk factors in women who have faced preeclampsia compared to those with normotensive pregnancies. The objective is to promote proactive assessment and timely implementation of preventative strategies.

In this retrospective cohort study, researchers collected data from adult women who had a history of preeclampsia within a postpartum timeframe of 0.5 to 30 years, alongside healthy women who had normotensive pregnancies. The cross-sectional postpartum assessments included evaluations of medical history, physical examinations, blood pressure measurements over 30 minutes, blood samples, 24-hour urine collections, vascular function tests, electrocardiograms, and echocardiograms.

The study included 1,040 women with a history of preeclampsia and 518 women following normotensive pregnancies. Findings revealed that women who had experienced preeclampsia exhibited significantly higher rates of hypertension, diabetes, and hypercholesterolemia compared to their normotensive counterparts. The adjusted hazard ratio was 2.6, with a 95% confidence interval of 2.1 to 3.2.

Notably, these cardiovascular risk factors were identified, on average, eight years earlier in the preeclampsia group (at around 39 years) compared to the normotensive group (at around 47 years). Additionally, the prevalence of hypertension increased more sharply with age in women who had preeclampsia, particularly after reaching 35 years of age, at which point the prevalence reached the threshold (>=10%) that necessitates systematic cardiovascular risk assessments.

The findings underscore the need for regular cardiovascular risk assessments for women with a history of preeclampsia, starting at the age of 35, with follow-up evaluations recommended at least every five years. This proactive approach could facilitate appropriate preventative measures to mitigate the heightened risk of cardiovascular diseases and their associated repercussions.

Experts emphasize the importance of continuous monitoring for these women, as they often do not receive specialized follow-up care after managing their preeclampsia. Maintaining a heart-healthy lifestyle and discussing cardiovascular risk assessments with healthcare professionals are crucial steps for women who have experienced preeclampsia.