title: Cardiovascular disease risk is only elevated in hypertensive, formerly preeclamptic women.
abstract: OBJECTIVE
  To analyse the predicted 10- and 30-year risk scores for cardiovascular disease (CVD) in patients who experienced preeclampsia (PE) 5-10 years previously compared with healthy parous controls.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Tertiary referral hospital in the Netherlands.
  
  
  METHODS
  One hundred and fifteen patients with a history of PE and 50 controls. PE patients were categorised into two groups, hypertensive (n = 21) and normotensive (n = 94), based on use of antihypertensive medication, and next categorised into subgroups based on the onset of PE: early-onset PE (n = 39) and late-onset PE (n = 76).
  
  
  METHODS
  All participants underwent cardiovascular risk screening 5-10 years after index pregnancy. We measured body mass, height and blood pressure. Blood was analysed for fasting glucose, insulin and lipid levels. All participants completed a validated questionnaire. The 10- and 30-year Framingham risk scores were calculated and compared.
  
  
  METHODS
  Estimated Framingham 10- and 30-year risk scores for CVD.
  
  
  RESULTS
  The overall 10- and 30-year CVD median risks weighing subjects' lipids were comparable between formerly PE women and controls; 1.6 versus 1.5% (P = 0.22) and 9.0 versus 9.0% (P = 0.49), respectively. However, hypertensive formerly PE women have twice the CVD risk as normotensive formerly PE women: 10- and 30-year CVD median risks were 3.1 versus 1.5% (P < 0.01) and 19.0% versus 8.0% (P < 0.01), respectively. Risk estimates based on BMI rather than lipid profile show comparable results. Early-onset PE clustered more often in the hypertensive formerly PE group and showed significantly higher 10- and 30-year CVD risk estimates based on lipids compared with the late-onset PE group: 1.7 versus 1.3% (P < 0.05) and 10.0 versus 7.0% (P < 0.05), respectively.
  
  
  CONCLUSIONS
  Women who are hypertensive after preeclampsia, have a twofold risk of developing CVD in the next 10-30 years. Formerly PE women who are normotensive in the first 10 years after their preeclamptic pregnancy have a comparable future cardiovascular risk to healthy controls.
authors.affiliation: Department of Obstetrics and Gynaecology, Research School GROW, Maastricht University Medical Centre (MUMC), Maastricht, the Netherlands.
authors.forename: N M
authors.initials: NM
authors.lastname: Breetveld
authors.affiliation: Department of Obstetrics and Gynaecology, Research School GROW, Maastricht University Medical Centre (MUMC), Maastricht, the Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Ghossein-Doha
authors.affiliation: Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.
authors.forename: Smj
authors.initials: S
authors.lastname: van Kuijk
authors.affiliation: Department of Cardiology, Radboud University Medical Centre (Radboudumc), Radboud, the Netherlands.
authors.forename: A P
authors.initials: AP
authors.lastname: van Dijk
authors.affiliation: Department of Cardiology, Radboud University Medical Centre (Radboudumc), Radboud, the Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: van der Vlugt
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Medical Centre (Radboudumc), Radboud, the Netherlands.
authors.forename: W M
authors.initials: WM
authors.lastname: Heidema
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Medical Centre (Radboudumc), Radboud, the Netherlands.
authors.forename: R R
authors.initials: RR
authors.lastname: Scholten
authors.affiliation: Department of Obstetrics and Gynaecology, Research School GROW, Maastricht University Medical Centre (MUMC), Maastricht, the Netherlands.
authors.forename: M E A
authors.initials: ME
authors.lastname: Spaanderman
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008055:Lipids / Q000097:blood; D009426:Netherlands / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D008055:Lipids
keywords: Cardiovascular risk; Framingham risk score; hypertension; metabolic syndrome; preeclampsia