Preeclampsia and the risk of cardiovascular disease later in life – A review of the evidence

The aim of the literature review was to explore and quantify the risks associated with preeclampsia (PET) and the incidence of cardiovascular disease (CVD) namely myocardial infarction and stroke in later life.Four databases used were searched: Ovid Medline, maternal and child health, Google Scholar and CINAHL with limits on years (2003-current), English language and full text.Any studies that included preeclampsia during pregnancy and where long term follow-up data were collected.Studies with longitudinal follow-up, cohort studies, females aged 18 years or over and those that included preeclampsia at any gestation in pregnancy were included while randomised controlled trials, short follow-up (i.e. not longitudinal) and studies pre-pregnancy or postpartum (within 6 weeks of birth) were excluded.Seven studies with over 4.93 million participants were identified as meeting the inclusion criteria. These studies demonstrated that PET is a strong marker of future CVD and a history of PET significantly increases the risk of hypertension later in life and subsequently increases the risk of other cardiovascular events in particular ischemic heart disease and stroke (both fatal and non-fatal).Early identification of CVD risk factors is an important public health issue and there needs to be greater awareness of hypertension and PET in pregnancy by both healthcare professionals and pregnant women.The evidence from the literature clearly demonstrates that PET is a risk factor for future CVD and the challenge will be to educate healthcare professionals in particular midwives, nurses, obstetricians and General Practitioners as well as the women with PET so that they can be involved in the long term management of CVD risk factors.