Severe Preeclampsia is Associated with a Positive Family History of Hypertension and Hypercholesterolemia

Roes, Eva Maria; Sieben, R.; Raijmakers, Maarten; Peters, Wilbert H.M.; Steegers, Eric A.P.

doi:10.1080/10641950500281076

Cited by 26 publications

(21 citation statements)

References 45 publications

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“…However, this observation is consistent with other published studies 39,40 and with the facts that preeclamptic subjects also had an increased prevalence of parental premature CVD and that women with recurrent abortion double the prevalence of parental hypertension in controls, without attaining statistical significance. The association between preeclampsia and parental history of CVDs may reflect a link among genetic, biochemical, environmental, and behavioral components, which predispose an individual to higher blood pressure and atheromatous disease.…”

Section: Discussionsupporting

confidence: 82%

Endothelial Dysfunction

et al. 2007

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Abstract-We tested the hypothesis that endothelial dysfunction could cause placentation-related defects, persist after the complicated pregnancy, and probably cause cardiovascular disease later in life. Brachial arterial reactivity and factors related to endothelial dysfunction, such as circulating cholesterol, uric acid, nitrites, L-arginine, asymmetrical dimethylarginine, vascular endothelial growth factor, and soluble vascular endothelial growth factor receptor-1, in women with previous healthy pregnancies (nϭ22), patients with severe preeclampsia (nϭ25), or patients with recurrent pregnancy loss (nϭ29), at day 10 of the luteal phase of an ovulatory cycle an average of 11 to 27 months after pregnancy were evaluated. Both groups with placentation defects had a significant decrease in endothelium-dependent dilatation, a higher rate of endothelial dysfunction, lower serum nitrites, and higher cholesterol as compared with control subjects; subjects with previous preeclampsia additionally had higher normal blood pressures and a greater parental prevalence of cardiovascular disease. Patients with recurrent pregnancy loss also demonstrated a significantly lower endotheliumindependent vasodilatation. A trend to an inverse correlation was found between serum cholesterol serum and endothelial-mediated vasodilatation in the whole study population. Uric acid, L-arginine, asymmetrical dimethylarginine, vascular endothelial growth factor, and soluble vascular endothelial growth factor receptor-1 were similar in all of the groups. We postulate that endothelial dysfunction may represent a link between preeclampsia and increased cardiovascular disease latter in life and propose that women with unexplained recurrent miscarriages are also at increased cardiovascular risk. The identification and correction of endothelial dysfunction detected during the reproductive stage on obstetric outcome and on cardiovascular diseases needs to be elucidated. Key Words: endothelial dysfunction Ⅲ endothelium-mediated vasodilatation Ⅲ pregnancy Ⅲ preeclampsia Ⅲ recurrent abortion Ⅲ cardiovascular risk P reeclampsia not only elevates obstetric morbidity and mortality, but also places the mother at increased risk for developing cardiovascular disease (CVD) later in life. Indeed, subjects with preeclampsia are susceptible to hypertension, obesity/metabolic syndrome, and to CVD particularly if the preeclampsia is complicated by preterm birth. [1][2][3][4] Interestingly, subjects with recurrent spontaneous abortions have also been reported to be at increased risk for the development of cerebrovascular disease later in life. 5 This suggests that there may be underlying risk factors of CVD that predispose to both preeclampsia and/or spontaneous abortions, 2 conditions that represent different degrees of placentation defects.One potential unifying mechanism could involve the presence of endothelial dysfunction before the obstetric complication. Maternal endothelial dysfunction could impair the invasion of extravillous trophoblasts into the spiral arter...

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Section: Discussionsupporting

confidence: 82%

Endothelial Dysfunction

et al. 2007

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“…These findings correspond with previous studies 27,31 and are consistent with the observation that preeclamptic women more frequently have a family history of hypertension. 10,13 Carotid IMT, which is used as a marker of subclinical atherosclerosis, 23,32 was increased in this specific subset of women who were diagnosed with chronic hypertension as compared with those without hypertension. In addition, we found that women with a history of preeclampsia have larger waist circumferences, as well as their mothers, when compared with control subjects.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] Common risk factors, such as obesity, hyperlipidemia, hypertension, and insulin resistance, are shared by these pregnancy disorders, as well as cardiovascular disease. 9 -12 Moreover, a positive family history of cardiovascular disease in women with preeclampsia has been reported 13 . In addition, endothelial dysfunction provides a link between the pathogenesis of these pregnancy disorders and future cardiovascular disease in that it predisposes to both placental dysfunction and atherosclerosis.…”

mentioning

confidence: 99%

Shared Constitutional Risks for Maternal Vascular-Related Pregnancy Complications and Future Cardiovascular Disease

Berends

Groot²,

Sijbrands³

et al. 2008

Hypertension

200

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Abstract-Maternal predisposition to vascular and metabolic disease may underlie both vascular-related pregnancy complications, such as preeclampsia and intrauterine growth restriction, as well as future maternal cardiovascular disease. We aimed to substantiate this hypothesis with biochemical and anthropometric evidence by conducting an intergenerational case-control study in a Dutch isolated population including 106 women after preeclampsia or intrauterine growth restriction (median follow-up: 7.1 years) and their fathers (nϭ43) and mothers (nϭ64), as well as 106 control subjects after uncomplicated pregnancies with their fathers (nϭ51) and mothers (nϭ68). Cardiovascular risk profiles were assessed, including fasting glucose, lipids, anthropometrics, blood pressure, intima-media thickness, and metabolic syndrome. We found significantly higher fasting glucose levels, larger waist circumferences, and a 5-fold increased prevalence of hypertension in women with a history of preeclampsia as compared with control subjects (PϽ0.001). Likewise, their parents had higher glucose levels than control parents (PϽ0.05). Their mothers had larger waist circumferences and higher blood pressures (PϽ0.05). Also, women after pregnancies complicated by intrauterine growth restriction had higher glucose levels and increased prevalence of hypertension (PϽ0.01). Their fathers showed higher glucose levels as well (PϽ0.05). Mean carotid intima-media thickness was increased in a subset of women after preeclampsia diagnosed with chronic hypertension as compared with those without hypertension (PϽ0.01). Metabolic syndrome was more prevalent both in women with a history of preeclampsia and their mothers (PϽ0.05). We demonstrated intergenerational similarities in cardiovascular risk profiles between women after preeclampsia or intrauterine growth restriction and their parents. These findings suggest shared constitutional risks for vascular-related pregnancy complications and future cardiovascular disease. (Hypertension. 2008;51:1034-1041.)

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“…Similarly, the presence of CV risk factors during the reproductive years may not have been evaluated in most of these patients, because the impact of such factors on gestation has been evident only recently. [23][24][25][26][27][28][29][30][31] Some reports do not differentiate between types of HPs, 7,11 and others show a greater association between preeclampsia and CV disease. 1,4,5,8,9 Based on these latter studies, our failure to characterize the different forms of HPs could have blunted their impact on coronary disease.…”

Section: Discussionmentioning

confidence: 99%

“…27 Based on the hypothesis that hypertension in pregnancy expresses underlying maternal conditions, we propose that proteinuric versus nonproteinuric HPs relate to CV complications through 2 different pathophysiologic pathways. In proteinuric HP (ie, preeclampsia), there may be an underlying endothelial dysfunction because of CV risk factors, [23][24][25][26][27][28][29][30][31][32]34,35,[37][38][39][40][41][42][43] which is exacerbated and clinically expressed by increased syncytiotrophoblast debris shedded into the maternal circulation. 44 -50 In nonproteinuric HP (ie, transient hypertension or exacerbation of an underlying hypertension), there is a restricted capacity to stimulate vasodilatory and antiaggregating factors (eg, prostacyclin, 51 tissue kallikrein, 52 and angiotensin- [1][2][3][4][5][6][7] 53 ); this limitation hampers the adaptation to the systemic hemodynamic changes of pregnancy 54 -57 and may favor CV disease later in life.…”

Section: Discussionmentioning

confidence: 99%

Association of Remote Hypertension in Pregnancy With Coronary Artery Disease

Valdés¹,

Quezada²,

Marchant³

et al. 2009

Hypertension

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Abstract-Because hypertensive pregnancies have been associated with increased cardiovascular disease, we aimed to identify whether angiographically characterized coronary artery disease differed in women with previous normotensive pregnancies or hypertensive pregnancies (HPs Key Words: hypertension in pregnancy Ⅲ preeclampsia Ⅲ coronary artery disease Ⅲ cardiovascular risks Ⅲ coronary angiography I ndirect evidence has linked preeclampsia, other forms of hypertension in pregnancy, and placentation-related defects to cardiovascular (CV) disease later in life. [1][2][3][4][5][6][7][8][9][10][11][12] Although most studies have used registry bases, one includes clinical follow-up, 10 one compares women with angiographically characterized coronary lesions with patients who only underwent clinical screening for coronary disease, 8 and another evaluates coronary calcification, a predictor of coronary artery disease. 11 A prospective study performed in a cohort of women with a precise classification of obstetric outcomes would be necessary to evaluate the tentative association between reproductive and CV complications, but because this is a relatively new finding, any ongoing or new study will need at least a couple of decades to be completed. Furthermore, included subjects would have to be left to the natural evolution of CV disease, and it is ethically inadmissible to abstain from CV preventive management.We decided to take an intermediate stance, by testing whether those subjects who had hypertensive pregnancies (HPs) developed earlier or more extensive coronary lesions than controls who had normotensive pregnancies (NPs). For this purpose, we evaluated the remote obstetric histories in women who underwent coronary angiography, the gold standard for defining coronary disease. MethodsThis investigation was a case-control observational retrospective study, with the results of coronary angiography as the dependent variable. Women undergoing coronary angiographies because of suspected coronary disease at Hospital Sótero del Río, in the southeast zone of Santiago, Chile, from January 1, 2006, to December 31, 2007, completed a questionnaire (please see the online data supplement at http://hyper.ahajournals.org) to determine their CV risk factors, including the following: family history; age of onset and end of menstrual cycles; hormonal replacement therapy; number of

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Severe Preeclampsia is Associated with a Positive Family History of Hypertension and Hypercholesterolemia

Abstract: Severe preeclampsia is associated with a positive family history of hypertension and/or hypercholesterolemia.

Cited by 26 publications

References 45 publications

Endothelial Dysfunction

Endothelial Dysfunction

Shared Constitutional Risks for Maternal Vascular-Related Pregnancy Complications and Future Cardiovascular Disease

Association of Remote Hypertension in Pregnancy With Coronary Artery Disease

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