Preeclampsia may be linked to heart disease

by Becky Gams, R.N., M.S., C.N.P.

January 5, 2006

Pregnancy-induced hypertension, or preeclampsia, is a condition that only occurs during pregnancy and is characterized by an increase in blood pressure and protein in the urine. It generally develops in the third trimester of the pregnancy, although in some cases it may develop in the late second trimester. Other symptoms include sudden weight gain, vision changes, headaches and nausea, upper abdominal pain, and vomiting.

Preeclampsia used to be called toxemia because it was thought to be caused by toxins in the body. Health providers now know that’s not the case, but currently there is no known cause. Preeclampsia affects between 5 and 8 percent of all pregnancies and is one of the leading causes of preterm delivery because the only treatment is delivery of the baby. For many women, the condition worsens quickly and health-care providers must intervene by delivering the baby early in order to save the mother’s life.

Preeclampsia is a leading cause of pregnancy-related deaths in the United States and worldwide. About 76,000 maternal deaths in the world annually are attributed to preeclampsia. New research also shows that women with a history of severe preeclampsia may have an increased risk of dying from heart disease 10 to 20 years after giving birth—a risk equal to smoking a pack of cigarettes a day.

Who is at greater risk for preeclampsia? 

• Those with a personal or family history of preeclampsia.
• Women in their first pregnancy or their first in more than 10 years.
• Women under age 18 or over age 40.
• Those who are overweight with a body-mass index (BMI) of 30 or more.
• Women expecting twins or triplets.
• Women already experiencing health conditions such as high blood pressure, diabetes, lupus or other autoimmune disorders, and women with a family history of high blood pressure, heart disease, or diabetes.

Are there long-term health risks associated with preeclampsia?

As noted above, research shows a link to heart disease. In addition, women who develop severe preeclampsia may be at higher risk for high blood pressure, elevated cholesterol, diabetes, and impaired kidney function. Fortunately, women can begin to take steps early in life to reduce their risk of heart disease, such as incorporating at least 30 minutes of physical activity into the daily routine, eating a heart-healthy diet, quitting smoking and avoiding second-hand smoke, maintaining a healthy weight, and limiting alcohol intake to one drink per day.

Women who have experienced severe preeclampsia should regularly visit a primary care provider, internist, or cardiologist familiar with preeclampsia. Also, women who developed preeclampsia and plan to have another child should consider having a preconceptual visit with an ob/gyn physician, certified nurse midwife, or maternal fetal medicine specialist. The provider will screen you for hypertension, diabetes, obesity, smoking, diet concerns, and asses your risk for developing heart conditions and pregnancy conditions.

Resources

• The Preeclampsia Foundation at www.preeclampsia.org
• A Body Mass Index calculator can be found at www.nhlbisupport.com/bmi/bmicalc.htm
• Information about the Dietary Approaches to Stop Hypertension can be found at  www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf
• A cardiovascular disease risk calculator can be found at www.heartdecision.org

Becky Gams, R.N., M.S., C.N.P., is the clinical coordinator at the University of Minnesota’s Deborah E. Powell Center for Women’s Health. This column is an educational service of the University of Minnesota. Advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to http://www.healthtalk.umn.edu.