Log in to MyACC
Early Coronary Atherosclerosis After Preeclampsia
Quick Takes
- Women with previous preeclampsia have slightly higher prevalence of coronary atherosclerosis than age- and parity-matched women.
Study Questions:
What is the prevalence of coronary atherosclerosis in younger women with previous preeclampsia?
Methods:
Women with and without previous preeclampsia (age 40-55 years) underwent a clinical exam and coronary computed tomography angiography (CTA). The primary outcome was the presence of any coronary atherosclerosis on coronary CTA or a calcium score >0 if the CTA was nondiagnostic.
Results:
Of 1,417 women, 708 had previous preeclampsia and 709 did not. Overall mean age was 47 years. Previous preeclampsia was associated with subsequent hypertension (284 [40.1%] vs. 162 [22.8%]; p < 0.001), dyslipidemia (338 [47.7%] vs. 296 [41.7%]; p = 0.023), diabetes mellitus (24 [3.4%] vs. 8 [1.1%]; p = 0.004), and high body mass index (27.3 ± 5.7 kg/m2 vs. 25.0 ± 4.2 kg/m2; p < 0.001). Coronary atherosclerosis was more prevalent in women with prior preeclampsia (193 [27.4%] vs. 141 [20.0%]; p = 0.001) with an odds ratio of 1.41 (95% confidence interval, 1.08-1.85; p = 0.012) after adjustment for age, dyslipidemia, diabetes mellitus, smoking, body mass index, menopause, and parity.
Conclusions:
Prior preeclampsia was associated with slightly higher prevalence of coronary atherosclerosis later in life, even after adjustment for traditional risk factors.
Perspective:
This study adds to the growing body of literature demonstrating the association of hypertensive disorders of pregnancy, especially preeclampsia, with increased future risk of cardiovascular disease. This is the largest study to investigate the higher prevalence of early coronary atherosclerosis by CTA after preeclampsia compared with age- and parity-matched women. Early awareness of cardiovascular risk after preeclampsia should lead to more effective interventions for risk reduction, but these need further development and study.
Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Dyslipidemia, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Prevention, Vascular Medicine, Atherosclerotic Disease (CAD/PAD), Interventions and Coronary Artery Disease, Interventions and Imaging, Interventions and Vascular Medicine, Angiography, Computed Tomography, Nuclear Imaging, Hypertension, Smoking
Keywords: Atherosclerosis, Body Mass Index, Computed Tomography Angiography, Coronary Angiography, Coronary Artery Disease, Diabetes Mellitus, Diagnostic Imaging, Dyslipidemias, Heart Disease Risk Factors, Hypertension, Pregnancy-Induced, Menopause, Parity, Plaque, Atherosclerotic, Pre-Eclampsia, Pregnancy, Primary Prevention, Risk Factors, Smoking, Women
< Back to Listings
