Pre-eclampsia and future cardiovascular diseases: How to assess the risk?

Abstract

In this issue of Atherosclerosis, Akhter and colleagues examined the cardiovascular risk in women with a history of pre-eclampsia and women with a history of normal pregnancies, performing repeat imaging (median follow up after pregnancy: 7 years) [ [1] Akhter T. Larsson A. Larsson M. Naessen T. Sub-clinical atherosclerosis in the common carotid artery in women with/without previous pre-eclampsia: a seven years follow-up. Atherosclerosis. 2019; 290: 206-213 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar ]. Imaging was performed using a high-resolution ultrasound system fitted with a broad-band probe at 22 MHz center frequency. The authors noted that the intima was thicker and the intima-to-media ratio was higher in pre-eclampsia cases compared to controls. These differences remained significant after adjusting for time to follow-up, blood pressure, and body mass index at follow-up. On the other hand, the common carotid artery intima/media thickness, which is most often used in carotid atherosclerosis assessment, was thinner [ [1] Akhter T. Larsson A. Larsson M. Naessen T. Sub-clinical atherosclerosis in the common carotid artery in women with/without previous pre-eclampsia: a seven years follow-up. Atherosclerosis. 2019; 290: 206-213 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar ]. Sub-clinical atherosclerosis in the common carotid artery in women with/without previous pre-eclampsia: A seven-year follow-upAtherosclerosisVol. 290PreviewPre-eclampsia is associated with increased risk of cardiovascular disease and premature death. However, conventional common carotid artery intima-media thickness (CCA-IMT) measurement does not reflect this. In contrast, measurement of the individual CCA intima and media thicknesses clearly indicates increased vascular risk both at diagnosis and about one year after pre-eclampsia. This study examined whether individual CCA wall layers, risk factors for cardiovascular disease, and markers of endothelial dysfunction had normalized or remained unfavorable seven years after pre-eclampsia. Full-Text PDF