Risk for coronary artery disease and morbid preeclampsia: a commentary.
OBJECTIVE
A predisposition to coronary artery disease (CAD) may put women at risk for preeclampsia. Morbid preeclampsia (early, severe, recurrent, and with neonatal morbidity) represents the subset of preeclampsia of greatest public health concern.


METHODS
We review here the published links between preeclampsia and CAD.


RESULTS
Many risk factors are common to both CAD and preeclampsia. These include obesity; elevated blood pressure; dyslipidemia; insulin resistance; and hyperglycemia, together termed "Syndrome X"; as well as endothelial dysfunction; hyperuricemia; hyperhomocysteinemia; and abnormalities of inflammation, thrombosis, and angiogenesis. After pregnancy, women with preeclampsia are more likely to experience later life CAD.


CONCLUSIONS
Both the association between CAD risk factors and preeclampsia and the association between preeclampsia and later CAD appears to be more pronounced among the subset of women with morbid preeclampsia. Thus, women at elevated risk for CAD may be at particularly high risk for morbid preeclampsia and women with morbid preeclampsia may be those at highest risk for later life CAD.
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA. repro@pitt.edu
Roberta B
RB
Ness
Carl A
CA
Hubel
D003324:Coronary Artery Disease / Q000453:epidemiology*; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012307:Risk Factors