Is there a link between pre-eclampsia history and increased markers of atherosclerosis?
Pre-eclampsia is a pregnancy complication marked by high blood pressure and organ damage. It is now recognized as a risk factor for future cardiovascular disease (CVD). Atherosclerosis is the buildup of plaque in arteries that can lead to heart attacks and strokes. Subclinical atherosclerosis refers to early, symptom-free changes that can be detected with imaging tests. The question is whether having had pre-eclampsia is linked to these early artery changes. The short answer is yes: multiple studies show that women with a history of pre-eclampsia have higher levels of subclinical atherosclerosis markers compared to women with uncomplicated pregnancies.
What the research says
A large meta-analysis of 35 case-control studies involving over 20,000 women found that a history of pre-eclampsia was associated with increased carotid intima-media thickness (CIMT), a measure of artery wall thickness and a marker of subclinical atherosclerosis 3. This difference was seen both during pregnancy and for more than 12 months after delivery 3. The same analysis also noted associations with other markers like coronary artery calcium and ankle brachial index, though fewer studies examined those 3.
Another study directly measured blood vessel function in women with and without a history of pre-eclampsia. It found that women who had pre-eclampsia showed impaired dilation of their arteries in response to both endothelium-dependent and endothelium-independent vasodilators, indicating poorer blood vessel health 7. This impairment was independent of blood pressure or body mass index, suggesting a lasting effect on the vascular system 7.
Reviews of the long-term cardiovascular impacts of pre-eclampsia confirm that women with a history of the condition have an increased risk of future CVD, and that structural and functional changes in the heart and blood vessels can be detected years after pregnancy 56. These changes include increased arterial stiffness and reduced ability of blood vessels to widen properly, which are early steps in the development of atherosclerosis 57.
What to ask your doctor
- Should I have screening for early signs of heart disease, such as a carotid ultrasound or coronary calcium scan?
- How often should I have my blood pressure, cholesterol, and blood sugar checked given my history of pre-eclampsia?
- Are there specific lifestyle changes or medications that can help reduce my future cardiovascular risk?
- What symptoms of heart disease should I watch for, and when should I seek medical attention?
- Is there any special monitoring needed if I become pregnant again?
This question is drawn from common patient questions about OB/GYN & Women's Health and answered using cited medical research. We do not provide individualized advice.