Abstract
Objective
To evaluate the development and management of cerebrovascular risk factors following
a pregnancy with preeclampsia.
Methods
This is a retrospective chart review including women diagnosed with preeclampsia between
2012 and 2013 with later encounters within 2014-2016. For each subject that met inclusion
criteria, the development of cerebrovascular risk factors was determined using ICD
codes within the 2014-2016 electronic medical record (EMR). For subjects who developed
risk factors, current treatment was determined from the EMR. Demographic data was
also documented. Differences in the development and treatment of risk factors were
compared among racial groups and age. Descriptive statistics were calculated using
SAS statistical software.
Results
Compared to prepregnancy health status, the incidence of hypertension increased by
1.7 times (P < .05), hyperlipidemia increased by 4.5 (P < .05), migraines increased by 2.2 (P < .05), and diabetes mellitus increased by 2 (P < .05) after a pregnancy with preeclampsia. Black non-Hispanics had highest rates
of hypertension, obesity, and migraines (20.5%, 9.1%, and 6.8%, respectively.) Of
hypertensives, 73.6% (42/57) were prescribed medication. Of diabetics, 88.9% (16/18)
were prescribed medication. No patients with hyperlipidemia were prescribed a statin.
Black non-Hispanics had higher rates of risk factor management (74.3% of hypertensives
and 100% of diabetics treated) than white Hispanics (55% and 77.8%, respectively).
Conclusions
This study shows a significant increased risk of the development of cerebrovascular
risk factors such as hypertension, hyperlipidemia, migraines, and diabetes following
a diagnosis of preeclampsia. Opportunities exist for the early treatment of these
risk factors, which could reduce the long-term rate of stroke in these women
Key Words
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References
- Trends in stroke hospitalizations and associated risk factors among children and young adults, 1995-2008.Ann Neurol. 2011; 70: 713-721
- Cardiovascular sequelae of preeclampsia/eclampsia: a systematic review and meta-analyses.Am Heart J. 2008; 156: 918-930
- 2013 aha/acc guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines.J Am Coll Cardiol. 2014; 63: 2960-2984
- Do young women need treatment for hypertension after pregnancy complications?.J Am Heart Assoc. 2018; 7
- Physicians' knowledge of future vascular disease in women with preeclampsia.Hypertens Pregnancy. 2012; 31: 50-58
- Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association.Stroke. 2014; 45: 1545-1588
- Acog practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002.Obstet Gynecol. 2002; 99: 159-167
- Prevention of vascular dysfunction after preeclampsia: a potential long-term outcome measure and an emerging goal for treatment.J Pregnancy. 2012; 2012704146
- Hypertensive disorders of pregnancy and future maternal cardiovascular risk.J Am Heart Assoc. 2018; 7e009382
- Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists: a presidential advisory from the American Heart Association and the American College of Obstetricians and Gynecologists.Circulation. 2018; 137: e843-e852
Article info
Publication history
Published online: March 24, 2020
Accepted:
February 2,
2020
Received in revised form:
January 27,
2020
Received:
August 26,
2019
Footnotes
This study was conducted at Jackson Memorial Hospital, an affiliate of the University of Miami Miller School of Medicine.
There was no grant support for this study.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104720
Copyright
© 2020 Elsevier Inc. All rights reserved.
