Preeclampsia’s lasting impact: the importance of lifelong cardiovascular health monitoring
In women who have suffered from preeclampsia during pregnancy, the risk for many cardiovascular diseases doubles: that’s why it’s important to keep it under control throughout life
Preeclampsia can develop during pregnancy and is characterized by an increase in blood pressure, often accompanied by proteinuria – higher levels of protein in the urine. If properly treated during gestation, the condition generally resolves itself within a few weeks after childbirth, but according to recent research, it could leave a long-term impact on the cardiovascular system, increasing the risk for various diseases, such as coronary heart disease, heart failure, and stroke.
A systematic review of the evidence available so far was recently published in the European Heart Journal thanks to the collaboration between Nicoletta Di Simone head of the Multidisciplinary Center for Pregnancy Pathology at Humanitas San Pio X and Director of the residency program in Gynecology and Obstetrics of Humanitas University – and Giulio Stefanini head of clinical research at the Humanitas Cardio Center and associate professor in Humanitas University. The study emphasizes the importance of prevention and lifelong cardiovascular monitoring in women who have suffered from preeclampsia.
What is Preeclampsia
It affects between 3% and 5% of all pregnant women, typically manifesting after the twentieth week of gestation. Among the symptoms that allow its recognition, in addition to the more characteristic hypertension and proteinuria, are widespread swelling (due to fluid retention), weight gain, headaches, and nausea.
“The cause of the condition is still under investigation, but it is likely related to inadequate development of the placental blood vessels. Risk factors include a family history of preeclampsia, obesity, being at the age extremes of the fertility spectrum (very young or over 40), having multiple pregnancies, and the presence of pre-existing medical conditions such as hypertension, diabetes, or kidney diseases. The use of in-vitro fertilization techniques is also a contributing factor,” explains Nicoletta Di Simone.
The onset can be sudden or slow, almost asymptomatic, only later progressing rapidly towards eclampsia. “If not properly treated, the condition can lead to serious complications for both the mother and the baby. However, research indicates that preeclampsia, even when adequately managed, has a lasting impact: the risk of developing cardiovascular diseases years later is twice as high compared to women who have not experienced it.”
New Evidence on the Relationship Between Preeclampsia and Cardiovascular Risk
As summarized by the recent systematic review published in the European Heart Journal, the risk is double particularly for cardiovascular death, coronary heart diseases, heart failure, and stroke. The increased risk shows itself clearly 1 to 3 years after childbirth and does not change for the subsequent 39 years of follow-up observed so far, thus lasting into old age.
The analysis – which includes 22 clinical studies conducted over the last twenty years, for a total of over 13 million women monitored – highlights the urgency of careful and continuous management of cardiac health in women who have experienced the condition.
“These data suggest the need for a change in the way the medical community approaches preeclampsia: no longer as a disorder confined to pregnancy, but as a warning sign for the woman’s future health. Therefore, the focus should be on prevention and long-term monitoring,” says Giulio Stefanini. “Based on our meta-analysis, prompt treatment of the condition can lessen its long-term impact and subsequently reduce the risk. This underscores the importance of being vigilant for any symptoms indicating its presence.”