History of Preeclampsia Multiplies CVD Risks


WASHINGTON — Women with a history of preeclampsia or eclampsia had more than twice the risk of developing cardiovascular disease than that of women with uncomplicated pregnancies, based on results of a meta-analysis that included more than 100,000 preeclamptic women.

Results from previous studies have shown associations between preeclampsia and increased risk of stroke and hypertension later in life.

To evaluate the long-term risk for cardiovascular problems in women with preeclampsia or eclampsia (referred to as PET), Dr. Sarah McDonald and her colleagues at McMaster University, Hamilton, Ont., conducted a meta-analysis of 5 case-control studies and 10 cohort studies. The studies included data from 118,990 preeclamptic women and 2.3 million women without PET.

The selected studies examined the development of cardiovascular disease or mortality at more than 6 weeks post partum in women with and without PET. Most (11 of 15) studies focused on women aged younger than 56 years.

The results were presented in a poster at the annual congress of the International Society for the Study of Hypertension in Pregnancy. Overall, there was a graded relationship between the severity of PET and the risk of cardiac disease. Women with severe PET had a fivefold increase in risk compared with women who did not have PET. The risk ratios for cardiac disease for mild, moderate, and severe PET were 2.00, 2.99, and 5.36, respectively.

In a pooled analysis of the case-control studies, women with a history of PET were more than twice as likely to develop cardiac disease (odds ratio 2.47). In a pooled analysis of the cohort studies, women with history of preeclampsia had a significantly increased risk of cardiac disease (relative risk 2.33), cardiovascular mortality (relative risk 2.29), cerebrovascular disease (relative risk 2.03), and peripheral artery disease (relative risk 1.87).

Despite the large numbers of patients in this meta-analysis, more research is needed to determine the mechanisms behind the association between PET and heart disease, and to develop interventions to prevent these complications, the researchers noted.

Dr. McDonald stated that she had no financial conflicts to disclose.

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