Preeclampsia Linked to Cardiovascular Problems After Pregnancy
TUESDAY June 24, 2008 -- Preeclampsia may change the way arteries respond to insulin, thereby increasing the risk of cardiovascular problems years after the dangerous pregnancy complication occurs, Scandinavian researchers report.
In this small study, researchers found an association between insulin sensitivity in women and a history of preeclampsia, which is high blood pressure during pregnancy.
"Although insulin sensitivity in non-obese women with previous preeclampsia is similar to that in control women, there was a significant correlation between waist-to-hip ratio and serum triglycerides and insulin sensitivity only in women with history of preeclampsia," said lead researcher Dr. Risto Kaaja, a researcher at Helsinki University Hospital in Finland.
"Secondly, insulin sensitivity correlated to vasodilatation again only in the preeclamptic group," Kaaja said. "Early-onset preeclampsia correlated to impaired insulin sensitivity later in life."
The study was published in the June 23 early online edition of Hypertension.
In the study, Kaaja's team looked at 28 non-obese women who had severe preeclampsia during pregnancy and compared them with 20 women who had normal pregnancies. After five to six years, researchers found an association between insulin sensitivity and dysfunction in the arteries among women with a history of preeclampsia, but not among women who had had normal pregnancies.
"We have been the first to suggest that preeclampsia could be the first manifestation of the metabolic syndrome," Kaaja said. "Although preeclampsia is mainly cured after delivery, features of the metabolic syndrome have been shown to prevail for months to several years after a preeclamptic pregnancy," he said.
"We showed that this impairment is related to insulin sensitivity and also with waist-to-hip ratio," Kaaja said, "meaning that women with history of preeclampsia could be more sensitive to harmful effects of gaining weight and increased waist-hip ratio, leading to insulin resistance and increased risk for atherosclerosis."
These women should be told about their increased risk for cardiovascular disease, Kaaja said.
Women with a normal waist-hip ratio who had preeclampsia should be careful not to gain weight later in life, Kaaja said.
In addition, blood pressure, cholesterol and blood sugar levels should be checked regularly among women with a history of preeclampsia. "With increasing waist-to-hip ratio, they will become insulin-resistant, and their vasodilatation will be impaired," Kaaja said. "Both factors, insulin resistance and impaired vasodilatation, lead to cardiovascular diseases."
Preeclampsia affects between 5 percent and 8 percent of all pregnancies. The condition is characterized by high blood pressure and protein in the urine. Common symptoms include swelling, sudden weight gain, headaches, and changes in vision. However, some women report few symptoms.
Dr. Byron Lee, an associate professor of cardiology at University of California, San Francisco, thinks this study helps explain why women with a history of preeclampsia are at risk for heart disease.
"Although we have known for awhile that women with a history of preeclampsia are at increased risk of coronary artery disease, we were not sure why," Lee said. "This study suggests that the body fat may be the link. Therefore, women who have had preeclampsia should be extra careful to keep off excess weight."
For more on preeclampsia, visit the National Institutes of Health.
Posted: June 2008