Pre-eclampsia linked to heart disease
2 November 2007
A UCL-led study published in this week's British Medical Journal (BMJ) adds further weight to the theory that pre-eclampsia and cardiovascular diseases may share common causes.
Dr David Williams (UCL Elizabeth Garrett Anderson Institute for Women's Health), found that women who have had pre-eclampsia during pregnancy have a more than two fold higher risk of heart disease in later life.
Pre-eclampsia is a serious condition of pregnancy causing high blood pressure in the mother and threatening the baby's wellbeing. It affects about five per cent of all first-time pregnancies, with delivery of the baby being the only cure.
Dr Williams and his team, which includes UCL's Dr Aroon Hingorani (UCL Medicine) analysed 25 studies involving over 3 million women. They calculated the future health risks of women who have had a pregnancy affected by pre-eclampsia that is likely explained by the association with heart disease.
Around 200,000 of the women developed pre-eclampsia. The main findings were that women who have had pre-eclampsia are at a four-fold increased risk of developing chronic hypertension and a two-fold risk of heart disease, stroke and venous thromboemolism (blood clots) in later life. They found no increase in risk of any cancer, including breast cancer, suggesting a specific relationship between pre-eclampsia and cardiovascular disease.
Dr Williams said: "Women who have had pre-eclampsia should be aware of this risk so that they can make lifestyle adjustments - such as keeping fit, losing weight, stopping smoking, monitoring and controlling their blood pressure and cholesterol as necessary - at a relatively young age to help lower their risk of heart disease."
"If pre-eclampsia proves to be a novel and independent risk-factor for heart disease, older women who have had pre-eclampsia and who attend for an assessment of their cardiovascular risk may be eligible for preventative therapies such as statins, at a younger age than if only classical risk factors for heart disease are considered."
A second study published in the BMJ by researchers in Norway shows that women may be predisposed to pre-eclampsia if they had cardiovascular risk factors present before they became pregnant. The authors examined whether cardiovascular risk factors assessed before conception predict pre-eclampsia.
Around 3,500 women were included in the analysis. Several cardiovascular risk markers, including blood pressure, cholesterol and blood sugar levels, weight, and body mass index, were recorded before pregnancy.
Nearly four per cent of these women had a pregnancy complicated by pre-eclampsia. After adjusting for factors such as smoking and social status, the researchers found that women with high pre-pregnant blood pressure, total cholesterol and blood sugar levels were seven times more likely to have pre-eclampsia compared to women with readings in the normal range.
In addition, a family history of high blood pressure, ischaemic heart disease, or diabetes was each associated with a doubling in risk, while overweight and obese women also had a higher risk compared to women of normal weight. Women who used oral contraceptives before pregnancy had half the risk of pre-eclampsia compared to never or previous users.
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Image: Pre-eclampsia causes high blood pressure for expectant mothers