Pre-Eclampsia During Pregnancy Could Indicate Future Heart Disease Risk, Studies Say

Women who experience pre-eclampsia during pregnancy have more heart attacks, strokes and blood clots later in life than women without the condition, according to several studies, the New York Times reports. Pre-eclampsia occurs in about 5% of pregnancies, affecting about 300,000 women annually in the U.S. According to the Times, researchers do not know what causes the condition, which is marked by high blood pressure, protein in the urine, severe swelling, headaches and vision problems. Although pre-eclampsia usually disappears soon after delivery, a "growing body of evidence" indicates that women who develop pre-eclampsia have twice the risk of having a heart attack or stroke later in life, the Times reports.

Graeme Smith, professor of obstetrics and gynecology at Queen's University in Ontario, currently is tracking about 600 women after pregnancy, half of whom had pre-eclampsia. For Smith's most recent study, published last month in the American Journal of Obstetrics and Gynecology, researchers compared 70 women from the pre-eclampsia group and 70 women without the condition. The study found that one year after delivery, women in the pre-eclampsia group had higher blood pressure, cholesterol, blood sugar and body mass index than the unaffected women. According to the Times, another study published this year found that women with pre-eclampsia were more likely to form blood clots and a 2007 study identified greater prevalence of artery hardening among women who had high blood pressure during pregnancy. David Williams, an obstetrician at the University College London, in 2007 published an analysis of 25 pre-eclampsia studies, finding that about four out of 100 women in their mid-40s with a history of normal pregnancy would be expected to have a heart attack or stroke 10 years later. Williams said that the proportion rises to eight out of 100 among women who had pre-eclampsia during pregnancy and that it rises even higher among women who have had pre-eclampsia more than once. Thomas Easterling, an obstetrician and pre-eclampsia researcher at the University of Washington Medical School, said data from such studies are "overwhelming." Smith added that such findings are "a wake-up call," particularly because the women with pre-eclampsia "are, for the most part, young, healthy women."














According to the Times, most researchers do not believe that pre-eclampsia directly increases the risk of heart disease. Smith said that it seems more likely that the condition is an early indicator of the health of a woman's heart. He called pregnancy a type of stress test, adding, "How much or how badly you fail that stress test really is an indicator of your future health risk." According to the Times, Williams now advises women with pre-eclampsia to have frequent screenings for cholesterol levels, blood sugar and blood pressure, and to seek treatment if the levels are high. However, barriers remain for increasing awareness of the link between pre-eclampsia and heart health. Smith said the association is "not readily appreciated by physicians," adding, "If you ask a cardiologist, they go, 'I never heard of it.'" According to Daniel Jones, dean of University of Mississippi School of Medicine and former president of the American Heart Association, an expert panel responsible for revising national blood pressure guidelines currently is evaluating the recent evidence linking pre-eclampsia to heart disease. Smith said increased awareness about the two conditions might allow physicians to identify a woman's heart disease risk sooner. "The earlier you diagnose them, the more likely you are to prevent cardiovascular disease," he said, adding, "This is an opportunity where people can change their future (Westphal, New York Times, 3/17).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2009 The Advisory Board Company. All rights reserved.