Maastricht: Women who have had preeclampsia are 2 to 8 times
more likely to develop cardiovascular problems in the future. Doctoral
research carried out by Chahinda Ghossein, research physician at the
Maastricht UMC+ Department of Gynaecology, has shown there is a link
between preeclampsia and heart failure. This will help provide
guidelines for research into the early detection of and preventative
measures for preeclampsia. Preeclampsia
usually occurs after the 20th week of pregnancy, with women experiencing
vascular problems in the form of high blood pressure combined with
proteinuria (protein loss in the urine). This is often accompanied by
restricted growth in the unborn child.
Research studyA total of 172,000 children were born in the Netherland during the research period, from June 2012 to May 2013. Approximately 11,000 women (6.4%) developed preeclampsia during their pregnancy. Pregnancy can be regarded as a stress test for a woman’s heart and blood vessels. During pregnancy, the mother’s heart becomes larger and the walls of the heart thicker. The diameter of the left heart chamber grows proportionally. In PE, however, the diameter of the mother’s left heart chamber appears not to grow proportionally, resulting in a similar clinical picture to that of patients with chronic heart failure. After a healthy pregnancy, the heart usually goes back to its normal size, but this is often not the case following preeclampsia. Blood pressure in the PE group appears to remain slightly raised after pregnancy. This increased blood pressure usually falls within the limits of what doctors consider to be normal, but it is clearly higher than in women who have not had PE. ‘On the basis of this research, it is advisable to offer women with preeclampsia special care, which is also referred to as cardiovascular risk management. It is certainly advisable to continue monitoring their blood pressure on a regular basis and, given the increased risk of cardiovascular disease in these women, it is advisable for these women to make lifestyle changes and to consider treatment. However, it is important that the effect of early treatment is examined first’, say the researchers.
Biomarkers
Since the initial study, a major follow-up study has begun, led by Prof. Spaanderman and subsidised by the Dutch Heart Foundation. This Queen of Hearts study (http://www.queen-of-hearts.eu/) is looking for specific signal substances (biomarkers) in order to better understand the risk of heart failure in women so that preventative measures can be taken and specific treatment can be started in good time. ‘This is important research indeed’ says Ghossein. ‘We know a lot less about women’s risk of developing heat failure than we do about men because most the research so far has been done on males. This has resulted in under-treatment, and heart failure in women is often only discovered at an advanced stage. We don’t want to wait until heart failure can be observed clinically, we want to be able to detect it at an early stage so that we can take the necessary steps in good time.’
Women can still register to take part in this major follow-up study. For further information, please see the website at http://gynaecologie.mumc.nl/transmuraal-vrouwen-dagcentrum