Risk of future cardiovascular disease in women with prior preeclampsia: a focus group study

Seely, Ellen W.; Rich‐Edwards, Janet W.; Lui, Janet; Nicklas, Jacinda M; Saxena, Akshar; Tsigas, Eleni; Levkoff, Sue E.

doi:10.1186/1471-2393-13-240

Cited by 61 publications

(84 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Women were invited to participate in a 90-minute phone-based focus group, as it has been shown that face-to-face focus groups are difficult for postpartum women to attend [7] and based on our prior experience with a similar population [6]. The use of phone-based focus groups also allowed us to recruit nationwide.…”

Section: Methodsmentioning

confidence: 99%

“…Based on the association between a history of preeclampsia and future hypertension and CVD, the American Heart Association (AHA) updated its recommendations for women in 2011, adding history of preeclampsia to the list of previously established risk factors for CVD (such as active smoking, hypertension or dyslipidemia) [5] and recommend lifestyle modification for women with this history. We previously demonstrated that women with a history of preeclampsia, on average 18 months postpartum, were generally unaware of the link between preeclampsia and future CVD; but once aware of the link, were interested in engaging in lifestyle modification to reduce this risk [6]. The purpose of the present focus groups was to identify specific barriers to learning about the link between a history of preeclampsia and future CVD risk, and to identify barriers to implementing and sustaining recommended healthy lifestyle changes to reduce the risk.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Improving the postpartum care of women with a recent history of preeclampsia: a focus group study

Skurnik

Roche

Stuart

et al. 2016

Hypertension in Pregnancy

Self Cite

View full text Add to dashboard Cite

Objective Women with prior preeclampsia are at increased risk of cardiovascular disease. This study investigated barriers and facilitators towards learning about this link and engaging in lifestyle modifications to reduce this risk. Methods Four focus groups were held with 14 women within six months of a preeclamptic pregnancy. Results Participants were unaware of the link between preeclampsia and cardiovascular disease, suggested improvements to provider-patient communication, and discussed the benefits of social support and online tracking (weight, blood pressure) in making lifestyle modifications. Conclusions Solutions offered may improve efforts to modify lifestyle and communication between providers and women about this link.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improving the postpartum care of women with a recent history of preeclampsia: a focus group study

Skurnik

Roche

Stuart

et al. 2016

Hypertension in Pregnancy

Self Cite

View full text Add to dashboard Cite

show abstract

“…In a focus group study, women with previous preeclampsia were found to be generally unaware of their increased risk of future cardiovascular diseases but were motivated to undertake lifestyle modifications to reduce risk. 50 In view of the burden and impact of cardiovascular disease on women in our society, we recommend a detailed cost-benefit analysis to determine the postnatal timing for a screening program in this high-risk population.…”

Section: Discussionmentioning

confidence: 99%

Preeclampsia and Future Cardiovascular Health

Haththotuwa

Kwok

et al. 2017

Circ: Cardiovascular Quality and Outcomes

784

335

View full text Add to dashboard Cite

P reeclampsia is a major cause of maternal mortality worldwide 1 and affects 2% to 8% of all pregnancies. 2,3 It is confined to pregnancy and defined as onset of hypertension after 20-week gestation with proteinuria, organ dysfunction, or uteroplacental dysfunction. 4 The pathogenesis of preeclampsia remains poorly understood and is thought to be because of the failure of spiral artery remodeling in the placenta causing placental hypoperfusion and hypoxia. The resultant oxidative stress triggers an excessive systemic inflammatory response, which causes endothelial dysfunction and vasoconstriction leading to systemic hypertension and end-organ hypoperfusion. 2,5 There is growing evidence that these effects on end organs persist after pregnancy.Cardiovascular disease is a leading cause of mortality globally and also of maternal death in the United Kingdom and United States. 6,7 Several studies have examined the relationship between preeclampsia and future incident cardiovascular disease, although the literature has been inconsistent. Some studies reported significantly higher risks of composite cardiovascular events or heart failure, 8,9 whereas others have not demonstrated such relationships. 10,11 It is unclear whether preeclampsia is an independent risk factor for future cardiovascular disease or an early marker of women with high-risk profiles for future cardiovascular disease. Factors that predispose women to preeclampsia are also found in the risk profile for cardiovascular diseases. These include obesity, 12 metabolic abnormalities, dyslipidemia, insulin resistance, 13 heightened inflammatory responses, hypercoagulable states, and endothelial dysfunction.14 Alternatively, the body may not fully recover from the damage to the Background-Preeclampsia is a pregnancy-specific disorder resulting in hypertension and multiorgan dysfunction. There is growing evidence that these effects persist after pregnancy. We aimed to systematically evaluate and quantify the evidence on the relationship between preeclampsia and the future risk of cardiovascular diseases. Methods and Results-We studied the future risk of heart failure, coronary heart disease, composite cardiovascular disease, death because of coronary heart or cardiovascular disease, stroke, and stroke death after preeclampsia. A systematic search of MEDLINE and EMBASE was performed to identify relevant studies. We used random-effects meta-analysis to determine the risk. Twenty-two studies were identified with >6.4 million women including >258 000 women with preeclampsia. Meta-analysis of studies that adjusted for potential confounders demonstrated that preeclampsia was independently associated with an increased risk of future heart failure (risk ratio ). Conclusions-Preeclampsia is associated with a 4-fold increase in future incident heart failure and a 2-fold increased risk in coronary heart disease, stroke, and death because of coronary heart or cardiovascular disease. Our study highlights the importance of lifelong monitoring of cardiovascular risk f...

show abstract

“…Laboratory diagnosis of the respondents which revealed increased proteinuria (48%), reduced urine output (26%), thrombocytopenia (19%) and impaired liver function (7%) may be adduced to the presence of biomolecules normally associated with pregnancy-induced hypertension/eclampsia (Mehta et al, 2015), which are potent risk factors. Clinical complications experienced by respondents which included 39% convulsion, 24% pulmonary edema, 20% kidney failure, 17% liver failure are indications of cardiovascular implications of preeclampsia/eclampsia (Seely et al, 2013;Burgess and Founds, 2016).…”

Section: Discussionmentioning

confidence: 99%

Determination, knowledge and prevalence of pregnancy-induced hypertension/eclampsia among women of childbearing age at Same District Hospital in Tanzania

Eze¹,

Barasa²,

Adams³

et al. 2018

Int. J. Med. Med. Sci.

View full text Add to dashboard Cite

Several risk factors including hypertension are common complications of pregnancy with preeclampsia particularly associated with substantial risk to both the mother and fetus. This cross-sectional study involving quantitative approach was conducted in Same District Hospital in Tanzania. Data were collected from all pregnant women in the hospital using questionnaires. Respondents' knowledge on maternal mortality regarding preeclampsia included those who had no knowledge 60(60%), and those who had knowledge 40(40%). Most of the respondents had no knowledge of maternal mortality due to the complications of preeclampsia. The study revealed that 64(64%), had positive attitude towards maternal mortality due to preeclampsia prevention while 36(36%) had no response. About 68(68%) of the respondents could not access the health facilities saying that these health facilities were not affordable citing that the distance was too long. They reported no health facilities and services as well as insecurity while looking for health facilities/services and finally that there were few health workers in the health facilities meaning that patients could not be attended to on time. Furthermore, health workers harassed the patients and make them seek other alternatives when they are sick, while minority 32(32%) said that the health facilities were accessible, affordable and efficient. Medical history during prenatal care showed that 25% of the respondent had increased blood pressure more than 140/90 mmHg, but only 10% had breath issues. Laboratory diagnosis of the respondents revealed increased proteinuria (48%) and impaired liver function (7%). Respondents experienced 39% convulsion and 24% pulmonary edema. Overall, the study identified a few predisposing factors to preeclampsia/eclampsia among pregnant women. Also, most of the respondents were said to have no knowledge of eclampsia thereby increasing maternal mortality.

show abstract

Risk of future cardiovascular disease in women with prior preeclampsia: a focus group study

Cited by 61 publications

References 16 publications

Improving the postpartum care of women with a recent history of preeclampsia: a focus group study

Improving the postpartum care of women with a recent history of preeclampsia: a focus group study

Preeclampsia and Future Cardiovascular Health

Determination, knowledge and prevalence of pregnancy-induced hypertension/eclampsia among women of childbearing age at Same District Hospital in Tanzania

Contact Info

Product

Resources

About