Pregnancy disorder signals need to screen for heart disease, study shows

November 05, 2008

High blood pressure experienced during pregnancy could be a woman's earliest warning that she is at risk of developing heart disease - the number one killer of Canadian women - says Queen's University professor of Obstetrics and Gynecology, Graeme Smith.

Called pre-eclampsia, this type of high blood pressure occurs in 5-10 per cent of all pregnancies.

But because most practicing physicians are unaware of the connection between pre-eclampsia and the risk for future cardiovascular problems, they fail to follow up with screening tests. As a result, their patients aren't taking proactive steps to avoid potential heart attacks and strokes.

According to the 2007 Heart and Stroke Foundation Annual Report on Canadians' Health, Canadian women have now caught up to men in cardiovascular deaths, with almost 37,000 deaths annually from heart disease and stroke.

"This should be on every obstetrician's and family doctor's radar screen," says Dr. Smith, an expert in high-risk obstetrics who is affiliated with Kingston General Hospital's Perinatal Research Unit. "What's exciting for our research team is that we're mostly dealing with young, healthy women who now have the opportunity to protect themselves from developing a life-threatening condition years down the road."

The findings are published on-line in the American Journal of Obstetrics and Gynecology.

The study, which began five years ago, has followed the progress of 400 Ontario women, half of whom developed pre-eclampsia during their pregnancy. When screened a year after delivery, the women with pre-eclampsia showed underlying cardiovascular risk factors of elevated blood pressure and lipids (fats) at a rate that was two to three times greater than the control group.

The researchers don't think that pre-eclampsia causes these symptoms, however. "They probably pre-dated pregnancy and were the background upon which pre-eclampsia developed," says Dr. Smith, who heads a multi-university research team studying pre-eclampsia. Instead, he suggests that pre-eclampsia is the earliest marker of potential future cardiovascular risk.

In a recent study showing that the incidence of hypertension (high blood pressure) in Ontario women of reproductive age is the same as the incidence of pre-eclampsia - about seven per cent - the researchers conducting the survey failed to ask women about their pregnancies. "The awareness isn't there yet," says Dr. Smith, suggesting that guidelines be established for longer-term follow-up.

Noting that pregnancy is a type of stress test for people who are already in the health care system, he adds: "It can reflect underlying problems that may be reduced by changes in lifestyle before medication is required."

Dr. Smith is leader of the Canadian Institutes of Health Research (CIHR) and Heart & Stroke Foundation Pre-Eclampsia New Emerging Team (PE-NET).

Other members contributing to the paper are: Melissa Swansburg, Heather Ramshaw and Michelle Roddy (from Queen's Department of Obstetrics and Gynecology); Mark Walker, Shi Wu Wen and Ruth Rennicks White (University of Ottawa); Michelle Hladunewich (U of T) and Aizhong Liu (Central South University, China).

Queen's University

---

---

	Pre-eclampsia: Etiology and Clinical Practice by Fiona Lyall (Editor), Michael Belfort (Editor) Pre-eclampsia is one of the leading causes of death and disability in mothers and babies. Over four million women worldwide will develop the disorder every year. This book, written by an international team of experts, focuses on both the scientific basis of pre-eclampsia and its management. The basic science section contains reviews of the most exciting research developments in pre-eclampsia. The clinical chapters provide a comprehensive review of the pertinent literature, highlighting data and ideas or developments in management. There is a section in each chapter (where relevant) that deals with practical management, giving clinicians a formulated treatment plan that they can implement directly. The book was originally published in 2007, and will have continuing relevance for all...
	Pre-eclampsia: Current Perspectives on Management by Philip Baker (Editor), John C. P. Kingdom (Editor) With its massive implications for both mothers and babies, pre-eclampsia continues to be one of the medical communities greatest challenges. Edited by renowned experts in this field, this book presents a comprehensive overview of pre-eclampsia. Providing a definition and classification of the disease, and the etiology and pathogenesis of the condition, the authors cover screening, presentation, and diagnosis, and review maternal and fetal complications. They take a multidisciplinary approach to labor ward management of the severe disease, anesthetic implications, and postpartum care. The book concludes with an examination of future therapeutic strategies and directions.
	Pre-eclampsia: Webster's Timeline History, 1951 - 2007 by Icon Group International (Author) Webster's bibliographic and event-based timelines are comprehensive in scope, covering virtually all topics, geographic locations and people. They do so from a linguistic point of view, and in the case of this book, the focus is on "Pre-eclampsia," including when used in literature (e.g. all authors that might have Pre-eclampsia in their name). As such, this book represents the largest compilation of timeline events associated with Pre-eclampsia when it is used in proper noun form. Webster's timelines cover bibliographic citations, patented inventions, as well as non-conventional and alternative meanings which capture ambiguities in usage. These furthermore cover all parts of speech (possessive, institutional usage, geographic usage) and contexts, including pop culture, the arts, social...
	Recurrent Miscarriage And Pre-eclampsia: The Roles Played By The Immune System And Antioxidants by Rhoda Wilson (Author) This book examines the role of antioxidants and of the immune system in the pathogenesis of pre-eclampsia and recurrent miscarriage. Whilst many papers have discussed the role of antioxidants in pre-eclampsia and, that of the immune system, hitherto publication has not considered the two simultaneously. The role of the immune system in recurrent miscarriage has been the subject of many papers but whether antioxidants play a part in miscarriage has been less well studied. In many ways the problems encountered in the two disorders are similar, and this book brings them together.
	Pre-eclampsia: The Facts: The Hidden Threat to Pregnancy (Oxford Medical Publications) by Chris Redman (Author), Isabel Walker (Author) Pre-eclampsia is the development of hypertension during pregnancy and the most common and the most potentially serious complication of pregnancy. It affects one out of every ten pregnancies, yet there is little known about the disease. This work informs pregnant women, family practitioners, and midwives of this usually symptomless, but often dangerous condition. It includes several illuminating case histories. Written by an expert in the field and a medical journalist who has suffered from pre-eclampsia, this book is a comprehensive and accessible portrait of the disease. It details all that is currently known about the origins and treatment of pre-eclampsia, and also provides advice for pregnant women.
	Pre-eclampsia by Hilary Critchley (Author), Allan MacLean (Author), Lucilla Poston (Author)
	Pre-eclampsia: risks at antenatal booking and recurrence across generations.(ROUND UP: Research): An article from: Reproductive Health Matters by Gale Reference Team (Author) This digital document is an article from Reproductive Health Matters, published by Thomson Gale on November 1, 2006. The length of the article is 510 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser. Citation Details Title: Pre-eclampsia: risks at antenatal booking and recurrence across generations.(ROUND UP: Research) Author: Gale Reference Team Publication: Reproductive Health Matters (Magazine/Journal) Date: November 1, 2006 Publisher: Thomson Gale Volume: 14 Issue: 28 Page: 214(1) Distributed by Thomson...
	Embarazadas: cuidado con la preclampsia.(TT: Pregnant women: carefull with pre-eclampsia): An article from: Contenido by Inés Olguín (Author) This digital document is an article from Contenido, published by Editorial Contenido, S.A. de C.V. on November 1, 1997. The length of the article is 1077 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser. Citation Details Title: Embarazadas: cuidado con la preclampsia.(TT: Pregnant women: carefull with pre-eclampsia) Author: Inés Olguín Publication: Contenido (Magazine/Journal) Date: November 1, 1997 Publisher: Editorial Contenido, S.A. de C.V. Issue: n413 Page: p70(3) Distributed by Thomson...
	Antiretroviral therapy in HIV positive pregnant women and risk of pre-eclampsia, fetal death, preterm birth and low birthweight.(ROUND UP: Maternal ... An article from: Reproductive Health Matters by Gale Reference Team (Author) This digital document is an article from Reproductive Health Matters, published by Thomson Gale on November 1, 2007. The length of the article is 447 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser. Citation Details Title: Antiretroviral therapy in HIV positive pregnant women and risk of pre-eclampsia, fetal death, preterm birth and low birthweight.(ROUND UP: Maternal Mortality and Morbidity)(Human immunodeficiency virus) Author: Gale Reference Team Publication: Reproductive Health Matters (Magazine/Journal) Date: November 1, 2007 Publisher: Thomson Gale Volume: 15 Issue: 30 Page:...
	Genes associated with endothelial function and risk of pre-eclampsia in an American Indian population.(COMMUNICATIONS--PROFESSIONAL)(Abstract): An ... of the North Dakota Academy of Science by Lyle G. Best (Author), Melanie Nadeau (Author), Shellee Bercier (Author), Sara Dauphinais (Author), Jacob Davis (Author), Kylie Davis (Author), Shyleen Poitra (Author), Cindy M. Anderson (Author) This digital document is an article from Proceedings of the North Dakota Academy of Science, published by North Dakota Academy of Science on April 1, 2009. The length of the article is 533 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available immediately after purchase. You can view it with any web browser. Citation Details Title: Genes associated with endothelial function and risk of pre-eclampsia in an American Indian population.(COMMUNICATIONS--PROFESSIONAL)(Abstract) Author: Lyle G. Best Publication: Proceedings of the North Dakota Academy of Science (Magazine/Journal) Date: April 1, 2009 Publisher: North Dakota Academy of Science Volume: 63 Page: 77(1) Article Type:...