American Journal of Obstetrics & Gynecology
Volume 200, Issue 1 , Pages 58.e1-58.e8 , January 2009

A history of preeclampsia identifies women who have underlying cardiovascular risk factors

  • Graeme N. Smith, MD, PhD

      Affiliations

    • Queen's Perinatal Research Unit, Department of Obstetrics and Gynecology, Kingston General Hospital, Queen's University, Kingston, ON, Canada
    • Corresponding Author InformationReprints: Graeme N. Smith, MD, PhD, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Kingston General Hospital, Queen's University, 76 Stuart St, Kingston, ON, Canada K7L 2V7
  • ,
  • Mark C. Walker, MD, MSc

      Affiliations

    • Ottawa Maternal Neonatal Investigators Research Group, Department of Obstetrics and Gynecology, Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
  • ,
  • Aizhong Liu, MB, PhD

      Affiliations

    • School of Public Health, Central South University, Changsha, Hunan, People's Republic of China
  • ,
  • Shi Wu Wen, MB, PhD

      Affiliations

    • Ottawa Maternal Neonatal Investigators Research Group, Department of Obstetrics and Gynecology, Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
  • ,
  • Melissa Swansburg, RN, MSc

      Affiliations

    • Queen's Perinatal Research Unit, Department of Obstetrics and Gynecology, Kingston General Hospital, Queen's University, Kingston, ON, Canada
  • ,
  • Heather Ramshaw, BSc

      Affiliations

    • Queen's Perinatal Research Unit, Department of Obstetrics and Gynecology, Kingston General Hospital, Queen's University, Kingston, ON, Canada
  • ,
  • Ruth Rennicks White, RN, BScN

      Affiliations

    • Ottawa Maternal Neonatal Investigators Research Group, Department of Obstetrics and Gynecology, Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
  • ,
  • Michelle Roddy, RN, BScN

      Affiliations

    • Queen's Perinatal Research Unit, Department of Obstetrics and Gynecology, Kingston General Hospital, Queen's University, Kingston, ON, Canada
  • ,
  • Michelle Hladunewich, MD, MSc

      Affiliations

    • Departments of Nephrology, Sunnybrook Health Sciences Centre and University Health Network, University of Toronto, Toronto, ON, Canada
  • ,
  • Pre-Eclampsia New Emerging Team (PE-NET)

Received 15 January 2008 ,Revised 2 May 2008 ,Accepted 11 June 2008.

References 

  1. Smith GCS, Pell JP, Walsh D. Pregnancy complications and maternal risk of ischaemic heart disease: a retrospective cohort study of 129,290 births. Lancet. 2001;357:2002–2006
  2. Ray JG, Vermeulen MJ, Schull MJ, Redelmeier DA. Cardiovascular health after maternal placental syndromes (CHAMPS): population-based retrospective cohort study. Lancet. 2005;366:1797–1803
  3. Funai EF, Paltiel OB, Malaspina D, Friedlander Y, Deutsch L, Harlap S. Risk factors for pre-eclampsia in nulliparous and parous women: the Jerusalem Perinatal Study. Paediatr Perinat Epidemiol. 2005;19:59–68
  4. Manten GTR, Sikkema MJ, Voorbij HAM, Visser GHA, Bruinse HW, Franx A. Risk factors for cardiovascular disease in women with a history of pregnancy complicated by preeclampsia or intrauterine growth restriction. Hypertens Pregnancy. 2007;26:39–50
  5. Forest J-C, Girouard J, Masse J, et al. Early occurrence of metabolic syndrome after hypertension in pregnancy. Obstet Gynecol. 2005;105:1373–1380
  6. Rodie VA, Freeman DJ, Sattar N, Greer IA. Pre-eclampsia and cardiovascular disease: metabolic syndrome in pregnancy?. Atherosclerosis. 2004;175:189–202
  7. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–2497
  8. Bar J, Kaplan B, Wittenberg C, et al. Microalbuminuria after pregnancy complicated by pre-eclampsia. Nephrol Dial Transplant. 1999;14:1129–1132
  9. North RA, Simmons D, Barnfather D, Upjohn M. What happens to women with preeclampsia? (Microalbuminuria and hypertension following pregnancy). Aust N Z J Obstet Gynaecol. 1996;36:233–238
  10. Agrawal B, Berger A, Wolf K, Luft FC. Microalbuminuria screening by reagent strip predicts cardiovascular risk in hypertension. J Hypertens. 1996;14:223–228
  11. Bianchi S, Bigazzi R, Campese VM. Microalbuminuria in essential hypertension: significance, pathophysiology, and therapeutic implications. Am J Kidney Dis. 1999;34:973–995
  12. Deckert T, Feldt-Rasmussen B, Borch-Johnsen K, Jensen T, Kofoed-Enevoldsen A. Albuminuria reflects widespread vascular damage: the Steno hypothesis. Diabetologia. 1989;32:219–226
  13. Jensen JS, Feldt-Rasmussen B, Strandgaard S, Schroll M, Borch-Johnsen K. Arterial hypertension, microalbuminuria, and risk of ischemic heart disease. Hypertension. 2000;35:898–903
  14. Agatisa PK, Ness RB, Roberts JM, Costantino JP, Kuller LH, McLaughlin MK. Impairment of endothelial function in women with a history of preeclampsia: an indicator of cardiovascular risk. Am J Physiol Circ Physiol. 2004;286:H1389–H1393
  15. Lampinen K, Ronnback M, Kaaja R, Groop P-H. Impaired vascular dilation in women with a history of pre-eclampsia. J Hypertens. 2006;24:751–756
  16. ACOG Practice Bulletin: diagnosis and management of preeclampsia and eclampsia. Obstet Gynecol. 2002;99:159–167
  17. Helewa ME, Burrows R, Smith J, Williams K, Brain P, Rabkin SW. Report of the Canadian Hypertension Society Consensus Conference: 1 (Definitions, evaluation and classification of hypertensive disorders in pregnancy). CMAJ. 1997;157:715–725
  18. O'Brien E, Asmar R, Beilin L, Imai Y, Mallion J. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens. 2003;21:821–848
  19. Brown MA, McHugh L, Mangos G, Davis G. Automated self-initiated blood pressure or 24-hour ambulatory blood pressure monitoring in pregnancy. Br J Obstet Gynaecol. 2004;111:38–41
  20. Beckett L, Godwin M. The BpTRU automatic blood pressure monitor compared to 24 hour ambulatory blood pressure monitoring in the assessment of blood pressure in patients with hypertension. BMC Cardiovasc Disord. 2005;5:18
  21. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostatic model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–419
  22. Romero-Gutierrez G, Malacara JM, Amador N, Fierro-Martinez C, Munoz-Guivara LM, Molina-Rodriguez R. Homeostatic model assessment and risk for hypertension during pregnancy: a longitudinal prospective study. Am J Perinatol. 2004;21:455–462
  23. World Health Organization (WHO). Definition, diagnosis and classification of diabetes mellitus and its complications, Part 1: diagnosis and classification of diabetes mellitus (WHO Department of Noncommunicable Disease Surveillance). Geneva (Switzerland): World Health Organization; 1999;
  24. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2004;27:S15–S35
  25. Cook NR, Buring JE, Ridker PM. The effect of including C-reactive protein in cardiovascular risk prediction models for women. Ann Intern Med. 2006;145:21–29
  26. National Heart, Lung, and Blood Institute. Report of the Working Group on Research on Hypertension During Pregnancy. Bethesda (MD): National Heart, Lung, and Blood Institute; 2001;
  27. Roberts JM, Gammill H. Insulin resistance in preeclampsia. Hypertension. 2006;47:341–342
  28. Magnussen EB, Vatten LJ, Lund-Nilsen TI, Salvesen KA, Smith GD, Romundstad PR. Prepregnancy cardiovascular risk factors as predictors of pre-eclampsia: population based cohort study. BMJ. 2007;335:978
  29. Sabour S, Franx A, Rutten A, et al. High blood pressure in pregnancy and coronary calcification. Hypertension. 2007;49:1–5
  30. Bellamy L, Casas JP, Hingorani AD, Williams DJ. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systemic review and meta-analysis. BMJ. 2007;335:974
  31. Sattar N, Greer IA. Pregnancy complications and maternal cardiovascular risk: opportunities for intervention and screening?. BMJ. 2002;325:157–160
  32. Irgens HU, Reisaeter L, Lie RT. Long term mortality of mothers and fathers after pre-eclampsia: population based cohort study. BMJ. 2001;323:1213–1217
  33. Nishimoto K, Shiiki H, Nishino T, et al. Glomerular hypertrophy in preeclamptic patients with focal segmental glomerulosclerosis (A morphometric analysis). Clin Nephrol. 1999;51:209–219
  34. Packham DK, Mathews DC, Fairley KF, Whitworth JA, Kincaid-Smith P. Morphometric analysis of pre-eclampsia in women biopsied in pregnancy and post-partum. Kidney Int. 1988;34:704–711
  35. Shiiki H, Dohi K, Hanatani M, et al. Focal and segmental glomerulosclerosis in preeclamptic patients with nephrotic syndrome. Am J Nephrol. 1990;10:205–212
  36. Lee HS, Kim TS. A morphometric study of preeclamptic nephropathy with focal segmental glomerulosclerosis. Clin Nephrol. 1995;44:14–21
  37. Nochy D, Heudes D, Glotz D, et al. Preeclampsia associated focal and segmental glomerulosclerosis and glomerular hypertrophy: a morphometric analysis. Clin Nephrol. 1994;42:9–17
  38. Thomas GN, Ho S-Y, Janus ED, et al. The US National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) prevalence of the metabolic syndrome in a Chinese population. Diabetes Res Clin Pract. 2005;67:251–257
  39. Wolf M, Hubel CA, Lam C, et al. Preeclampsia and future cardiovascular disease: potential role of altered angiogenesis and insulin resistance. J Clin Endocrinol Metab. 2004;89:6239–6243
  40. Nardi O, Zureik M, Courbon D, Ducimetiere P, Clavel-Chapelon F. Preterm delivery of a first child and subsequent mothers' risk of ischaemic heart disease: a nested case-control study. Eur J Cardiovasc Prev Rehabil. 2006;13:281–283
  41. Catov JM, Newman AB, Roberts JM, et al. Preterm delivery and later maternal cardiovascular disease risk. Epidemiology. 2007;18:733–739
  42. Isomaa B, Almgren P, Tuomi T, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001;24:690–694
  43. Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14,719 initially healthy American women. Circulation. 2003;107:391–397
  44. Stehouwer CDA, Gall M-A, Twisk JWR, Knudsen E, Emeis JJ, Parving H-H. Increased urinary albumin excretion, endothelial dysfunction, and chronic low-grade inflammation in type 2 diabetes: progressive, interrelated, and independently associated with risk of death. Diabetes. 2002;51:1157–1165
  45. Roberts JM, Gammill H. Pre-eclampsia and cardiovascular disease in later life. Lancet. 2005;366:961–962
  46. Levenson JW, Skerrett PJ, Gaziano M. Reducing the global burden of cardiovascular disease: the role of risk factors. Prev Cardiol. 2002;5:188–199

 Cite this article as: Smith GN, Walker MC, Liu A, et al. A history of preeclampsia identifies women who have underlying cardiovascular risk factors. Am J Obstet Gynecol 2009;200:58.e1-58.e8.

 This study was supported by Grants from the Canadian Institutes of Health Research (FMI-63194) and the Heart and Stroke Foundation (PG-03-0175-PE-NET).

PII: S0002-9378(08)00646-7

doi: 10.1016/j.ajog.2008.06.035

American Journal of Obstetrics & Gynecology
Volume 200, Issue 1 , Pages 58.e1-58.e8 , January 2009