Pre-eclampsia and increased cardiovascular risk

Cardiovascular disease is the leading cause of death in women.1 Although its incidence is declining in men, this is not the case in women.2

Pre-eclampsia is a novel cardiovascular risk marker. Pre-eclampsia increases both the long term risk of cardiovascular disease and the risk that it will occur earlier. This has been shown consistently over time, in different settings, and for coronary and cerebrovascular outcomes. The magnitude of the risk for cardiovascular disease in women with previous pre-eclampsia is similar to that of dysplipidaemia.3 Risk seems to be greater for pre-eclampsia than for gestational (or “pregnancy induced”, non-proteinuric) hypertension. Risk is also greater for early-onset pre-eclampsia and for pre-eclampsia associated with placental complications (such as stillbirth or small for gestational age infants).4 Two papers in this week's BMJ assess the link between pre-eclampsia and cardiovascular disease.5 6

In the first paper, Bellamy and colleagues summarise the consistency and strength of the association between pre-eclampsia and long term risk of cardiovascular disease.5 They confirm the dose-response relation between …