Research Article| Volume 29, ISSUE 6, 104720, June 2020

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Tracking the Development of Cerebrovascular Risk Factors Following Pregnancy With Preeclampsia



      To evaluate the development and management of cerebrovascular risk factors following a pregnancy with preeclampsia.


      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.


      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).


      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

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        • George M.G.
        • Tong X.
        • Kuklina E.V.
        • et al.
        Trends in stroke hospitalizations and associated risk factors among children and young adults, 1995-2008.
        Ann Neurol. 2011; 70: 713-721
        • McDonald S.D.
        • Malinowski A.
        • Zhou Q.
        • et al.
        Cardiovascular sequelae of preeclampsia/eclampsia: a systematic review and meta-analyses.
        Am Heart J. 2008; 156: 918-930
        • Eckel R.H.
        • Jakicic J.M.
        • Ard J.D.
        • et al.
        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
        • Aye C.Y.L.
        • Elmahi E.
        • Boardman H.
        • et al.
        Do young women need treatment for hypertension after pregnancy complications?.
        J Am Heart Assoc. 2018; 7
        • Young B.
        • Hacker M.R.
        • Rana S.
        Physicians' knowledge of future vascular disease in women with preeclampsia.
        Hypertens Pregnancy. 2012; 31: 50-58
        • Bushnell C.
        • McCullough L.D.
        • Awad I.A.
        • et al.
        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
        • Bulletins–Obstetrics ACoP
        Acog practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002.
        Obstet Gynecol. 2002; 99: 159-167
        • Lazdam M.
        • Davis E.F.
        • Lewandowski A.J.
        • et al.
        Prevention of vascular dysfunction after preeclampsia: a potential long-term outcome measure and an emerging goal for treatment.
        J Pregnancy. 2012; 2012704146
        • Ying W.
        • Catov J.M.
        • Ouyang P.
        Hypertensive disorders of pregnancy and future maternal cardiovascular risk.
        J Am Heart Assoc. 2018; 7e009382
        • Brown H.L.
        • Warner J.J.
        • Gianos E.
        • et al.
        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