18: Classic risk factors predictive of first cardiovascular events in women with a history of early-onset preeclampsia: Opportunities for primary prevention

Article Outline

• Objective
• Study design
• Results
• Conclusion
• Copyright

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Objective 

Women with a history of early-onset preeclampsia are at increased risk of developing major cardiovascular disease (CVD) related events, that have a detrimental effect on their long-term health and life expectancy. In this follow-up study, we measured established risk factors predictive of first CVD events after early-onset preeclampsia.

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Study design 

Over a 10-year interval, 243 primiparous women with a history of early-onset preeclampsia (delivery <34 weeks gestation) were included and tested for major cardiovascular risk factors at least six months after delivery, in addition to a population-based control group of 374 healthy non-pregnant women. Women with chronic hypertension were excluded.

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Results 

Mean age was 30.5 years for cases compared to 28.3 years for controls (P<.001). After adjustment for age, we observed significantly increased mean values for weight (P=.002), body-mass index (P<.001), systolic blood pressure (P<.001), diastolic blood pressure (P<.001), total cholesterol (P=.006), LDL cholesterol (P<.001), triglycerides (P=.027), fasting blood glucose (P<.001), and lower HDL cholesterol (P<.001) in women with previous early-onset preeclampsia. No difference was found for height, smoking, diabetes, and ethnicity. Estimated 10-year risk of first CVD events by Framingham Risk Scores remained <10% for all women (low-risk). Nonetheless, at mean (SD) 0.7 (1.0) years after early-onset preeclampsia, 15% of women met the criteria for metabolic syndrome. Additionally, 89% of women exhibited >=1, 51% of women >=2 and 19% of women >=3 major CVD risk factors.

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Conclusion 

The majority of women with a history of early-onset preeclampsia exhibit at least one modifiable risk factor for future CVD. Although most of these women are classified as low-risk according to the current AHA guidelines, this is mainly due to their young age masking other, mostly modifiable, major risk factors. Our data thus support life-style intervention programs aimed at primary prevention of CVD in women with a history of early-onset preeclampsia.