Hemostatic abnormalities may predict chronic hypertension after preeclampsia

Preeclampsia is a pregnancy-induced hypertensive disease. About 25-30% of women suffering from this disease will later, while still fertile, develop essential hypertension.

Various hemostatic variables known to increase the risk of cardiovascular complications were investigated in 28 women with severe preeclampsia and 14 with mild preeclampsia 6-15 months after delivery.

High levels of the coagulation inhibitors protein C and total protein S were found in the women with severe preeclampsia (p < 0.001). The levels of prothrombin complex, fibrinogen, plasminogen activator inhibitor-1 were increased in women who had previously had severe preeclampsia as compared to those who had had mild preeclampsia (p < 0.01). The levels of the four markers for thrombin activity (thrombin-antithrombin complex, prothrombin fragments 1 + 2, fibrin D-dimers and soluble fibrin) were higher in the severe preeclampsia group. In 12 women in this group (43%), the levels of three to four variables were higher than the reference ranges (mean +/- 2 SD). In patients with earlier severe or mild preeclampsia, factor VII antigen was also found to be increased as compared to normal fertile women (p < 0.02).

Women with earlier severe preeclampsia displayed increased levels of coagulation factors and the main fibrinolytic inhibitor, high levels of which are known to predict cardiovascular events. This was also reflected by increased levels of thrombin markers.