Pre-eclampsia May Predict Heart, Renal Disease

By Megan Brooks

January 16, 2015

NEW YORK (Reuters Health) - Women with a history of pre-eclampsia - particularly severe pre-eclampsia or multiple episodes - are at increased risk for developing atherosclerotic disease, researchers from Israel observed in a population-based study.

"This study further establishes this link between pre-eclampsia and long-term cardiovascular morbidity (and) establishes a new link between pre-eclampsia and future risk for renal morbidity," Dr. Eyal Sheiner, of Soroka University Medical Center in Beer Sheva, told Reuters Health by email.

This knowledge, he added, "may help when performing risk assessment for future cardiovascular and renal morbidity for women and also serve as an opportunity to recommend women regarding specific surveillance and lifestyle modifications."

The study, published online January 6 in Heart, included all 96,370 women who delivered between 1988 and 2012 at Soroka University Medical Center, the sole hospital of the Negev in the southern region of Israel.

Overall, 7824 women (8.1%) were diagnosed at least once with pre-eclampsia. During roughly 11 years of follow up, these women had higher rates of cardiovascular morbidity, including cardiac non-invasive (odds ratio 1.4, p=0.005) and invasive diagnostic procedures (OR 1.7, p=0.001), simple (OR 1.5, p=0.001) and complex cardiovascular events (OR 2.4, p=0.001) and renal (OR 3.7, p=0.001) hospitalizations.

The researchers observed a clear and significant dose-response association between the severity of pre-eclampsia and cardiovascular risk (2.7% with no pre-eclampsia vs 4.5% with mild, 5.2% with severe pre-eclampsia and 5.7% with eclampsia; p=0.001). The same was true for renal disease (0.1% vs 0.2% vs 0.5% vs 1.1%, respectively; p=0.001).

They also observed a linear association between the number of episodes of pre-eclampsia and the risk for simple cardiovascular disease (1.2% with no pre-eclampsia vs 1.6% with one episode vs 2.2% with two or more episodes; p=0.001), risk for complex cardiovascular disease (1.3% vs 2.7% vs 4.6%, respectively; p=0.001) and total cardiovascular hospitalizations (2.7% vs 4.4% vs 6.0%, p=0.001).

Pre-eclampsia remained independently associated with atherosclerotic hospitalizations in a Cox proportional hazards model adjusted for confounding factors such as maternal age, parity, diabetes mellitus and obesity, the researchers say.

"This information is of major importance when counseling future risk for cardiovascular and renal morbidity in patients with previous episodes of pre-eclampsia," they conclude.

The study had no commercial funding and the authors have declared no competing interests.

SOURCE: http://bmj.co/1Cqf77p

Heart 2015.

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