1. Home>
2. Specialties>
3. Women's Health>
4. Summary and Comment

The Link Between Preeclampsia and Future Atherosclerosis

Data suggest that impaired insulin sensitivity underlies the development of both preeclampsia and atherosclerosis in some women.

Preeclampsia, which shares numerous features with atherosclerosis, is believed to be a risk factor for later coronary heart disease. These researchers sought to determine whether several nontraditional risk factors are linked to risk for future cardiovascular events in preeclamptic women. Forty primigravid women who gave birth between 1975 and 1985 and had preeclampsia (diastolic blood pressure, >90 mm Hg; proteinuria, >2+) were compared, 15 to 25 years later, with a control group of 40 women who were matched for time of pregnancy, smoking status, and current BMI.

At the time of the index pregnancy, median BMI was significantly greater, median gestation was significantly shorter, and median birth weight of babies was significantly lower among preeclamptic women than among controls. At the time of reevaluation, median diastolic BP was significantly higher among formerly preeclamptic women than among controls. Formerly preeclamptic women also had significantly higher median plasma concentrations of the endothelial inflammatory markers intracellular adhesion molecule-1 (ICAM-1) and vascular cellular adhesion molecule-1; the difference in ICAM-1 concentration persisted after adjustment for menopausal status, medication use, social class, age, BMI, and smoking status. In addition, women with histories of preeclampsia had a higher median fasting insulin level (P=0.08) and a significantly greater median HbA_1c concentration. Lipid values did not differ significantly between the 2 groups.

Comment: These findings suggest that impaired insulin sensitivity underlies the development of both preeclampsia and atherosclerosis in some women. More extensive risk-factor assessment will be warranted if additional research confirms these findings. For now, greater attention to modification of treatable risk factors for atherosclerosis can be advocated for women who develop preeclampsia.

— Marian C. Limacher, MD

Published in Journal Watch Women's Health September 23, 2003

Citation(s):

Sattar N et al. Classic and novel risk factor parameters in women with a history of preeclampsia. Hypertension 2003 Jul; 42:39-42.

• Original article (Subscription may be required)
• Medline abstract (Free)