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Long-term maternal cardiovascular risk after preeclampsia: a latent vascular enemy
  1. Monica Acevedo1,
  2. Paola Varleta2,
  3. Rodrigo Tagle3
  1. 1 División de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
  2. 2 Centro Cardiovascular, Hospital DIPRECA, Las Condes, Santiago, Chile
  3. 3 Departamento de Nefrología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
  1. Correspondence to Professor Monica Acevedo, División de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; macevedo{at}

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Preeclampsia is a hypertensive pregnancy disorder characterised by ‘de novo’ hypertension after the 20th week of gestation, accompanied by proteinuria and evidence of acute maternal kidney injury, liver dysfunction, neurological features, haemolysis or thrombocytopenia. Preeclampsia is a serious pregnancy clinical condition associated with intrauterine growth retardation and stillbirths, responsible for approximately 30% of maternal deaths worldwide.1

Primary maternal risk factors for preeclampsia include pre-existing hypertension or pregestational diabetes, obesity, kidney disease, antiphospholipid syndrome, multiparity/nulliparity, previous preeclamptic event and pregnancy-assisted reproduction, among others.2 Therefore, assessing and detecting these risk factors in pregnant women is crucial. In this regard, obstetricians can promote early intervention, recommending exercise, prescribing aspirin and calcium supplementation and following them rigorously throughout the pregnancy using maternal-fetal ultrasound (to monitor uteroplacental flow) and serum biomarkers as needed.1

Even though preeclampsia is a gestational disease, the maternal risk does not cease after delivery. History of preeclampsia is associated with at least twice the risk of cardiovascular disease (CVD) in the following 5 to 15 years.1 2 Data from a meta-analysis had shown that preeclampsia gives a fourfold increase in heart failure and hypertension, 2–2.5 relative risk of coronary artery disease (CAD), 1.5–3.1 of cerebrovascular disease and ~1.87-fold of peripheral artery disease. In addition, women with early onset preeclampsia (<37 weeks) have a higher risk of CVD than those with late-onset. Also, when preeclampsia is associated with intrauterine growth retardation, preterm birth or a stillbirth, CAD risk is even higher.3

The report of Ray et al,4 studying the presence of premature severe obstructive CAD in women with preeclampsia, published in …

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  • Contributors Writing of the manuscript: MA. Critical revision of the manuscript for intellectual content: all authors. Authors responsible for the overall content as guarantors: all authors. Figure: PV and MA.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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