title: Co-occurrence of cardiovascular and prothrombotic risk factors in women with a history of preeclampsia.
abstract: OBJECTIVE
  Formerly preeclamptic women are at increased risk for remote cardiovascular and thrombotic diseases. We studied co-occurrence of cardiovascular and prothrombotic risk factors within a cohort of formerly preeclamptic women and tested if prevalence of these risk profiles related to onset of preeclampsia in previous pregnancy.
  
  
  METHODS
  We evaluated 1,297 nonpregnant formerly preeclamptic women (6-12 months postpartum) for the presence of four risk profiles: circulatory risk profile (hypertension or latent hypertension [low plasma volume, increased vascular resistance, or both]; metabolic syndrome (World Health Organization criteria); thrombophilia (factor V Leiden, prothrombin mutation, or protein C or S deficiency); and hyperhomocysteinemia. Trends between prevalence of these four profiles and onset of preeclampsia were studied using linear regression analysis.
  
  
  RESULTS
  After exclusion of 63 women (4.9%) because of incomplete data, 1,234 women were included. One or more risk profiles were detected in 958 of 1,234 (77.6%) formerly preeclamptic women. Circulatory risk profile was more prevalent (66.1%) than hyperhomocysteinemia (18.7%), metabolic syndrome (15.4%), or thrombophilia (10.8%). Prevalence of circulatory risk profile, metabolic syndrome, and hyperhomocysteinemia decreased significantly with gestational age at delivery, whereas thrombophilia did not (P=.22). There was minimal overlap (less than 2%) between metabolic syndrome, thrombophilic profile, and hyperhomocysteinemia.
  
  
  CONCLUSIONS
  Circulatory risk profile is present in two thirds of formerly preeclamptic women. Metabolic syndrome, thrombophilia, and hyperhomocysteinemia are prevalent in 10-20%. There is considerable overlap between circulatory risk profile and other profiles, but not among the three other profiles. Prevalence of these risk factors, except thrombophilia, decreases with gestational age at delivery in preceding pregnancy.
  
  
  METHODS
  : II.
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. r.scholten@obgyn.umcn.nl
authors.forename: Ralph R
authors.initials: RR
authors.lastname: Scholten
authors.forename: Maria T E
authors.initials: MT
authors.lastname: Hopman
authors.forename: Fred C G J
authors.initials: FC
authors.lastname: Sweep
authors.forename: Maureen J
authors.initials: MJ
authors.lastname: Van de Vlugt
authors.forename: Arie P
authors.initials: AP
authors.lastname: Van Dijk
authors.forename: Wim J
authors.initials: WJ
authors.lastname: Oyen
authors.forename: Fred K
authors.initials: FK
authors.lastname: Lotgering
authors.forename: Marc E A
authors.initials: ME
authors.lastname: Spaanderman
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D036861:Delivery, Obstetric; D005165:Factor V / Q000235:genetics / Q000502:physiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D006973:Hypertension / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D009154:Mutation; D010953:Plasma Volume / Q000502:physiology; D011225:Pre-Eclampsia / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D011247:Pregnancy; D015995:Prevalence; D011486:Protein C / Q000032:analysis; D017293:Protein S / Q000032:analysis; D011516:Prothrombin / Q000235:genetics / Q000502:physiology; D012189:Retrospective Studies; D012307:Risk Factors; D019851:Thrombophilia / Q000097:blood / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology; D013927:Thrombosis / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D014655:Vascular Resistance / Q000502:physiology
chemical_list: D011486:Protein C; D017293:Protein S; C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin