Heart disease risk assessment should look at preeclampsia

When assessing women for risk of cardiovascular disease, a history of preeclampsia should be taken into account, and women with cardiovascular disease may be more prone to preeclampsia, according to two studies published online Nov. 1 in BMJ.

In one study, Elisabeth Balstad Magnussen, of the Norwegian University of Science and Technology in Trondheim, Norway, and colleagues studied 3,494 women, of whom 133 had a preeclamptic pregnancy, and found a positive association between pre-pregnancy triglyceride levels, cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol and blood pressure, and preeclampsia. Use of oral contraceptives at baseline reduced the risk of pre-eclampsia by half compared with those who had never or no longer used them.

In a second study, Leanne Bellamy, a medical student at Imperial College School of Medicine in London, UK, and colleagues reviewed studies with a combined data set of 3,488,160 women, of whom 198,252 were affected by preeclampsia. The data also comprised 29,495 episodes of cardiovascular disease and cancer. The data showed no association between history of preeclampsia and cancer risk, but pointed to increased risk of various types of cardiovascular disease including hypertension, ischemic heart disease, stroke, and venous thromboembolism. Overall mortality was also increased after preeclampsia with a relative risk of 1.49 after 14.5 years.

Magnussen EB, Vatten LJ, Lund-Nilsen TI, et al. Prepregnancy cardiovascular risk factors as predictors of pre-eclampsia: population based cohort study. BMJ. 2007;335:978. Published online November 1, 2007. Available at: http://www.bmj.com/cgi/content/abstract/bmj.39366.416817.BEv1/.

Bellamy L, Casas JP, Hingorani AD, et al. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. 2007;335:974.