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Risk for coronary artery disease and morbid preeclampsia: a commentary
1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA. repro@pitt.edu
Insights
Women with a predisposition to coronary artery disease (CAD) face higher risks for preeclampsia. Morbid preeclampsia significantly increases the likelihood of developing CAD later in life.
Area of Science:
- Cardiovascular Medicine
- Obstetrics
- Public Health
Background:
- Coronary artery disease (CAD) and preeclampsia share common risk factors.
- Morbid preeclampsia, a severe form, poses significant public health challenges.
Purpose of the Study:
- To review the established links between preeclampsia and CAD.
- To identify shared risk factors and outcomes between these conditions.
Main Methods:
- Literature review of published studies.
- Analysis of common risk factors and associations.
Main Results:
- Shared risk factors include obesity, hypertension, dyslipidemia, insulin resistance, hyperglycemia (Syndrome X), endothelial dysfunction, hyperuricemia, hyperhomocysteinemia, and inflammation.
- Women with preeclampsia have an increased risk of developing CAD later in life.
Conclusions:
- The association between CAD risk factors and preeclampsia is stronger in cases of morbid preeclampsia.
- Women with morbid preeclampsia are at a heightened risk for developing CAD later in life.
Purpose:
A predisposition to coronary artery disease (CAD) may put women at risk for preeclampsia. Morbid preeclampsia (early, severe, recurrent, and with neonatal morbidity) represents the subset of preeclampsia of greatest public health concern.
Methods:
We review here the published links between preeclampsia and CAD.
Results:
Many risk factors are common to both CAD and preeclampsia. These include obesity; elevated blood pressure; dyslipidemia; insulin resistance; and hyperglycemia, together termed "Syndrome X"; as well as endothelial dysfunction; hyperuricemia; hyperhomocysteinemia; and abnormalities of inflammation, thrombosis, and angiogenesis. After pregnancy, women with preeclampsia are more likely to experience later life CAD.
Conclusions:
Both the association between CAD risk factors and preeclampsia and the association between preeclampsia and later CAD appears to be more pronounced among the subset of women with morbid preeclampsia. Thus, women at elevated risk for CAD may be at particularly high risk for morbid preeclampsia and women with morbid preeclampsia may be those at highest risk for later life CAD.
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