Pre-Eclampsia Increases Stroke Risk Later in Life

April 28, 2021
Women who had pre-eclampsia during pregnancy are at least 3 times more likely to have a stroke later in life than women who did not have a history of pre-eclampsia, according to a study published in JAMA Network Open. “Our study strongly suggests that, for women who have a history of pre-eclampsia, physicians should consider aggressive treatment of midlife vascular risk factors, including high blood pressure and elevated cholesterol and glucose levels,” said Adam de Havenon, University of Utah, Salt Lake City, Utah. “Doing this could potentially reduce the risk of these women having strokes.” Previous research found an association between pre-eclampsia and stroke, but did not follow women through midlife or track the development of risk factors for stroke such as high blood pressure, cholesterol, blood glucose, or smoking. For the current study, Dr. de Havenon and colleagues analysed data from 1,435 women who had given birth and participated in the Framingham Heart Study. Participants were evaluated every 2 years, from 1948 to 2016. None of the women had had a stroke prior to enrollment in the Framingham study. However, 169 had pre-eclampsia prior to participation. Women who had this condition were more likely to be younger, smoke, have higher diastolic blood pressure, and receive treatment for high cholesterol than other women evaluated. Over an average follow-up of 32 years, 231 women had a stroke. After accounting for the development of traditional vascular risk factors over time, a history of pre-eclampsia was found to be independently associated with about a 3.8-fold higher risk for having stroke later in life. Although the researchers acknowledged that much remains unknown about the association between pre-eclampsia and stroke, they suspect pre-eclampsia may cause more long-term damage than previously thought, making a woman more susceptible to stroke as she ages. “Pre-eclampsia is a complicated disease involving injury to the lining of the blood vessels,” said Lauren Theilen, MD, University of Utah. “We used to think it just happened while you were pregnant, then it healed afterward. But preeclampsia may be doing lasting damage to the blood vessels.” The current study has many of the same limitations as the original Framingham Heart Study. Among them is that pre-eclampsia was self-reported. As a result, some women may not have disclosed that they had had the condition. The Framingham study also did not enroll non-White women, making it hard to generalise these findings to other racial or ethnic groups. Information about physical activity and diet, two factors that could affect vascular health in midlife, weren’t available. Reference: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778939 SOURCE: University of Utah Health