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Preeclampsia raises risks for future myocardial infarction, ischemic stroke

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February 2, 2023

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The odds of myocardial infarction and ischemic stroke are greater between women with and without pre-eclampsia over 20 years of pregnancy. European Journal of Preventive Cardiology.

“High risk of cardiovascular disease after preeclampsia appears at a young age and in the early postnatal period.” Sara Halm, PhD, “This is an intervention to prevent heart attacks and strokes in affected women compared to conventional cardiovascular medicine,” he said in a press release. It just shows that you can’t wait until you’re middle-aged to be eligible for a screening program.”

Data obtained from Hallum S et al. Cardiol before Eur J2023;doi:10.1093/eurjpc/zwad003.

Using linked data from multiple Danish registries, Hallum et al. found that among 1,157,666 women who lived or had stillbirths from 1978 to 2017, there was no circulatory failure before their first pregnancy. identified a woman.

As primary outcomes, the investigators investigated whether women diagnosed with pre-eclampsia, eclampsia or HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome in the prenatal months and women who were not diagnosed with acute myocardial infarction (MI) and The risk of ischemic stroke was calculated. Within 7 days after giving birth. Each woman was followed until the primary outcome occurred, death or emigration, the end of the study period, or her 20 years after first birth.

In total, 64,357 of the 58,120 women had pregnancies complicated by pre-eclampsia. Within her 20 years of first pregnancy, 3,089 women developed acute myocardial infarction and 5,119 women developed ischemic stroke as the first ischemic event.

20-year incidence of acute composite endpoints MI or ischemic stroke was 1.84% (95% CI, 1.68-2) in women <35 years with pre-eclampsia and 0.96% (95% CI, 0.93-0.98) in women <35 years without pre-eclampsia ) was. The composite endpoint incidence for women aged ≥35 years at delivery was 4.13% (95% CI, 3.2-5.06) with pre-eclampsia and 2.13% (95% CI, 1.98-2.28) without pre-eclampsia .

acute myocardial infarction

Compared with no preeclampsia, preterm preeclampsia (HR = 2.84; 95% CI, 2.44-3.3) and full-term preeclampsia (HR = 1.67; 95% CI, 1.53-1.82) were associated with acute It was associated with higher MI odds.

The association was strongest among young women and women whose last child was within 10 years. At 10 years postpartum, women with and without pre-eclampsia had a 4-fold higher risk than her (HR = 4.16; 95% CI, 3.16–5.49). Twenty years after her delivery, women with and without pre-eclampsia had twice her risk (HR = 1.98; 95% CI 1.49–2.64).

ischemic stroke

Similar to its association with acute myocardial infarction, pre-eclampsia ischemic stroke 10 years postpartum (HR = 2.59; 95% CI, 2.04-3.28). At 20 years postpartum, pre-eclamptic women had a higher risk of ischemic stroke (HR = 1.96; 95% CI, 1.55-2.48).

In particular, preterm preeclampsia was most strongly associated with ischemic stroke (HR = 2.2; 95% CI 1.92-2.51).

“Women often come into contact with the health care system during and shortly after pregnancy, providing an opportunity to identify women at increased risk for cardiovascular disease,” Halm said in a release. We need to start within 10 years, for example by treating high blood pressure and educating women about heart disease risk factors such as smoking and inactivity.”


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