Does preeclampsia put women at higher risk of cardiac problems later?

Yes, there is definitely a correlation between preeclampsia - high blood pressure and protein in the urine during pregnancy - and cardiovascular problems in later life. But it's not clear whether preeclampsia itself is the culprit or whether women who get preeclampsia were already at risk of future cardiovascular problems before they got pregnant, said Dr. Richard J. Levine, an epidemiologist at the National Institute of Child Health and Human Development at the National Institutes of Health.

Preeclampsia almost always occurs about halfway through a normal, 40-week pregnancy. It's quite common, occurring in roughly 5 percent of pregnancies, and accounts for about 15 percent of premature births as well as the death of several hundred Americans per year, according to the Preeclampsia Foundation.

Recent research shows that preeclampsia is caused by an imbalance between two kinds of factors, those that turn on and those that shut down new blood vessel growth, said Dr. Benjamin Sachs, formerly the head of obstetrics at Beth Israel Deaconess Medical Center and now dean of the Tulane University School of Medicine.

At the beginning of pregnancy, a woman has to create more blood vessels to increase the blood supply to a growing baby, a process called angiogenesis. At the end of pregnancy, this process needs to be reversed, otherwise a woman could bleed heavily. In preeclampsia, the shutdown of blood vessel growth occurs too early which can lead to damage to blood vessels, the kidneys, liver, and brain, Sachs said.

The bottom line is that women who have had preeclampsia should be extra careful throughout their lives to monitor blood pressure and cholesterol, control weight, and take blood pressure-lowering medication if necessary.

It's not clear yet whether the babies of women who have preeclampsia are also at increased risk of cardiovascular problems later in life.

JUDY FOREMAN

E-mail health questions to foreman@globe.com.