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ESC Congress 2003: Preeclampsia is a risk factor for coronary artery disease in women
August 31, 2003IMPORTANT: This press release accompanies a poster or oral session given at the ESC Congress 2003. Written by the investigator himself/herself, this press release does not necessarily reflect the opinion of the European Society of Cardiology
We have shown that hypertension related to pregnancy (preeclampsia) is a risk factor for developing coronary artery disease in relatively young (less than 65 years of age) women. Given that 5-10% of women have hypertensive pregnancy this could be an important step to start prevention before menopausal age.
Coronary artery disease (CAD) is a major cause of death in Europe. Its incidence has decreased during latest decade, but less in women than in men. The reason for this gender difference might be explained by different CAD risk factor profile with obesity, smoking, hypertension, and type 2 diabetes mellitus being more important risk factors for women than men. They are also known to be related a different form of CAD (than in men) affecting more often small heart vessels, which are less accessible for coronary by-pass and angioplasty. This highlight the role of prevention in which pregnancy history could offer very valuable information.
Preeclampsia is a major cause of maternal and fetal morbidity and mortality complicating 5-10% of pregnancies. It is characterised by high blood pressure and proteinuria. The mechanisms for preeclampsia are not well understood but vascular dysfunction is one of the major causal factors. Preeclampsia and CAD share common risk factors for vascular dysfunction such as hypertension, diabetes, obesity, dyslipidemia, increased insulin resistance (loss of insulin action in the body).
Our study was carried out in Helsinki University Hospital during the years 1996-2000. 141 parous women aged less than 65 years of age were diagnosed with CAD at the Department of Cardiology. They had been referred to coronary angiography because of symptoms of CAD or having suffered an acute myocardial infarction (heart attack). During the same time period, we collected control groups from hospital and private clinic. Self-administered questionnaires were sent to the patients and controls and the information was confirmed from their obstetric hospital records. The questionnaire included information on risk factors for CAD (with recent laboratory documentation), obstetric history particularly presence of hypertensive pregnancies.
The patients and control women showed different CAD risk profiles. The CAD patients were more often smokers, more obese, had more often hypertension, type 2 diabetes, and hypercholesterolemia than the controls. The CAD patients had more often preeclampsia in the first or in any pregnancy than the controls. In statistical analysis the age of „d 55 years, obesity (BMI of „d 28kg/m2), smoking, hypertension, preeclampsia in any pregnancy, type 2 diabetes and hypercholesterolemia were all independent risk factors for CAD. Use of HRT tended to be protective against CAD (borderline significant)
Our results are in good agreement with our earlier studies showing that preeclampsia is a state of loss of insulin action (insulin resistance) which can still be observed 17 years after preeclamptic pregnancy. This would indicate that the tendency to loss of insulin action may persist whole life and accentuate in and after postmenopause and aggravate vascular dysfunction and atherosclerosis leading to narrowing of the arteries (also coronary arteries). Our women with CAD were more obese, had more often hypertension more often than control women and most probably they were more insulin resistant than the controls.
As our study showed that a history of preeclampsia is a risk factor for subsequent CAD, it is important to advise women with preeclampsia to avoid obesity and stop smoking, as well as prevent and treat hypertension and hyperlipidemia.
Dr Risto Juhani Kaaja
Helsinki University Hospital, Finland
European Society of Cardiology (ESC)
Preeclampsia is a major cause of maternal and fetal morbidity and mortality complicating 5-10% of pregnancies. It is characterised by high blood pressure and proteinuria. The mechanisms for preeclampsia are not well understood but vascular dysfunction is one of the major causal factors. Preeclampsia and CAD share common risk factors for vascular dysfunction such as hypertension, diabetes, obesity, dyslipidemia, increased insulin resistance (loss of insulin action in the body).
Our study was carried out in Helsinki University Hospital during the years 1996-2000. 141 parous women aged less than 65 years of age were diagnosed with CAD at the Department of Cardiology. They had been referred to coronary angiography because of symptoms of CAD or having suffered an acute myocardial infarction (heart attack). During the same time period, we collected control groups from hospital and private clinic. Self-administered questionnaires were sent to the patients and controls and the information was confirmed from their obstetric hospital records. The questionnaire included information on risk factors for CAD (with recent laboratory documentation), obstetric history particularly presence of hypertensive pregnancies.
The patients and control women showed different CAD risk profiles. The CAD patients were more often smokers, more obese, had more often hypertension, type 2 diabetes, and hypercholesterolemia than the controls. The CAD patients had more often preeclampsia in the first or in any pregnancy than the controls. In statistical analysis the age of „d 55 years, obesity (BMI of „d 28kg/m2), smoking, hypertension, preeclampsia in any pregnancy, type 2 diabetes and hypercholesterolemia were all independent risk factors for CAD. Use of HRT tended to be protective against CAD (borderline significant)
Our results are in good agreement with our earlier studies showing that preeclampsia is a state of loss of insulin action (insulin resistance) which can still be observed 17 years after preeclamptic pregnancy. This would indicate that the tendency to loss of insulin action may persist whole life and accentuate in and after postmenopause and aggravate vascular dysfunction and atherosclerosis leading to narrowing of the arteries (also coronary arteries). Our women with CAD were more obese, had more often hypertension more often than control women and most probably they were more insulin resistant than the controls.
As our study showed that a history of preeclampsia is a risk factor for subsequent CAD, it is important to advise women with preeclampsia to avoid obesity and stop smoking, as well as prevent and treat hypertension and hyperlipidemia.
Dr Risto Juhani Kaaja
Helsinki University Hospital, Finland
European Society of Cardiology (ESC)
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Diabetes surgery summit consensus lays foundation for new field of medicine
A first-of-its-kind consensus statement on diabetes surgery is published online today in the Annals of Surgery.
ESC to give talks on Diabetes in three cities in China
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New research shows versatility of amniotic fluid stem cells
For the first time, scientists have demonstrated that stem cells found in amniotic fluid meet an important test of potential to become specialized cell types, which suggests they may be useful for treating a wider array of diseases and conditions than scientists originally thought.
First reconstitution of an epidermis from human embryonic stem cells
Stem cell research is making great strides. This is yet again illustrated by a study carried out by the I-STEM* Institute (I-STEM/ Inserm UEVE U861/AFM), published in the Lancet on 21 November 2009. The I-STEM team, directed by Marc Peschanski has just succeeded in recreating a whole epidermis from human embryonic stem cells.
An atomic-level look at an HIV accomplice
Since the discovery in 2007 that a component of human semen called SEVI boosts infectivity of the virus that causes AIDS, researchers have been trying to learn more about SEVI and how it works, in hopes of thwarting its infection-promoting activity.
Scripps research scientists find new link between insulin and core body temperature
A team led by scientists at The Scripps Research Institute have discovered a direct link between insulin-a hormone long associated with metabolism and metabolic disorders such as diabetes-and core body temperature.
Scientists find molecular trigger that helps prevent aging and disease
Researchers at Mount Sinai School of Medicine set out to address a question that has been challenging scientists for years: How do dietary restriction-and the reverse, overconsumption-produce protective effects against aging and disease?
Pivotal study for PSD502 -- the first potential treatment for premature ejaculation
At the annual meeting of the Sexual Medicine Society of North America (SMSNA), Inc. in San Diego, Sciele Pharma, Inc., a Shionogi Company and Plethora Solutions Limited, a wholly owned subsidiary of Plethora Solutions Holdings PLC ("Plethora" - AIM:PLE)., today presented data from its second positive pivotal study of PSD502 for the treatment of premature ejaculation (PE).
Night Beat, Overtime and a Disrupted Sleep Pattern Can Harm Officers' Health
A police officer who works the night shift, typically from 8 p.m. to 4 a.m., already is at a disadvantage when it comes to getting a good "night's" sleep.
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