Timely assessment of cardiovascular risk after preeclampsia

Evaluation of: Cusimano MC, Pudwell J, Roddy M, Chan-Kyung JC, Smith GN. The maternal health clinic: an initiative for cardiovascular identification in women with pregnancy-related complications. Am. J. Obstet. Gynecol. 438, e1 (2014). Cardiovascular risk management, for men and women alike, is a preventative means to detect individuals' running an elevated risk of myocardial disorders, stroke and metabolic syndrome. Because age is an important factor in the risk assessment, especially young women almost always are classified in the low-risk category and therefore do not qualify for preventive treatment. A history of preeclampsia identifies women who have underlying cardiovascular risk factors. Approximately 6-8% of all pregnancies are complicated by hypertensive disorders, about 2% ends in preeclampsia. For that very reason, the Maternal Health Clinic at Kingston General Hospital in Kingston, Canada, was established to provide postpartum cardiovascular risk counseling or follow-up for women with the pregnancy-related complications. The outcomes were significant: 17% of the young target population with an average age of 33 years met criteria of metabolic syndrome and 85% revealed elevated lifetime cardiovascular disease risk. These figures are to be compared with control results of women with uncomplicated pregnancies: 7% metabolic syndrome and 46% non-optimal risk. It is concluded that the clinic may serve as a prolific and effective primary prevention strategy.