Preeclampsia and Cardiovascular Disease in a Large UK Pregnancy Cohort of Linked Electronic Health Records– A CALIBER Study
Circulation. 2019;140:1050–1060, https://doi.org/10.1161/CIRCULATIONAHA.118.038080
Lydia J. Leon, Fergus P. McCarthy, Kenan Direk, Arturo Gonzalez-Izquierdo, David Prieto-Merino, Juan P. Casas, Lucy Chappell
Vitamin D treats preeclampsia.
Perhaps Vitamin D should be continued after birth
Report on this study by the New York Times
Hypertension in Pregnancy May Portend Cardiovascular Ills in Mothers
- "Hypertension in pregnancy, or pre-eclampsia, affects between 3 percent and 10 percent of pregnant women in the United States"
- 12% of those with preeclampsia later had cardiovascular problems
| Increase | Cardiovascular problem after birth |
| 1.9 X | stroke |
| 1.7 X | cardiac atherosclerotic events |
| 1.8 X | peripheral events |
| 2.1 X | heart failure |
| 1.7 X | atrial fibrillation, |
| 2.1 X | cardiovascular deaths |
| 4.5 X | chronic hypertension |
Items in both categories Pregnancy and Hypertension (proxie for preeclampsia):
- Preeclampsia (low vitamin D) doubles the risk of later cardiovascular problems – Sept 2019
- Preeclampsia 11X more likely if poor Vitamin D Binding Protein (South Africa) - Sept 2019
- Preeclampsia 2X more likely if poor Vitamin D Receptor – April 2019
- Preeclampsia reduced 1.7 X by aspirin (but reduced 7 X by Vitamin D) – Feb 2018
- Preeclampsia risk reduced 7X by 4,000 IU of Vitamin D daily – RCT March 2018
- Preeclampsia of offspring cut in half if mother who smoked had vitamin D fortified margarine – Dec 2017
- Preeclampsia reduced 2X by Vitamin D, by 5X if also add Calcium – meta-analysis Oct 2017
- Child 49 percent higher risk of being overweight if hypertension during pregnancy – Sept 2017
- Preeclampsia risk reduced 60 percent if supplement with Vitamin D (they ignored dose size) – meta-analysis Sept 2017
- Preeclampsia recurrence reduced 2 X by 50,000 IU of vitamin D every two weeks – RCT July 2017
- Preeclampsia is not reduced by vitamin D (if you ignore vitamin D level, dose size, frequency and duration) – July 2017
- Preeclampsia doubles the risk of mild cognitive impairment – July 2017
- No Hypertension during pregnancy if more than 60 ng of vitamin D – RCT
- Preeclampsia changes to Vitamin D Binding Protein reduces Vitamin D in placenta – Dec 2016
- Preeclampsia risk reduced by higher levels of vitamin D (VDAART 4,400 IU) - RCT Nov 2016
- MAGNESIUM IN MAN - IMPLICATIONS FOR HEALTH AND DISEASE – review 2015
- Preeclampsia 4X less likely if vitamin D levels increased by 8 ng during pregnancy – March 2016
- Pre-eclampsia 2X more likely if low vitamin D, unless adjust for vitamin D factors (BMI, skin color) – Dec 2015
- Preeclampsia and eclampsia associated with lower vitamin D, etc. – Sept 2015
- Preeclampsia increased risk of Congenital Heart Defects by 60 percent (vitamin D not mentioned) Oct 2015
- Preeclampsia reduced by Vitamin D (50,000 IU bi-weekly) and Calcium – Oct 2015
- Burkas reduce vitamin D levels, which causes pregnancy problems – Oct 2015
- Preeclampsia – hypothesis as to why vitamin D helps – June 2015
- Preeclampsia inversely proportional to serum Magnesium – Oct 2014
- Hypertension in pregnancy (preeclampsia) more frequent in winter (low vitamin D) – Jan 2015
- Preeclampsia rate cut in half by high level of vitamin D – meta-analysis March 2014
- Preeclampsia 40 percent less likely if mother had more than 20 ng of vitamin D – Jan 2014
- Preeclampsia 2.7X more frequent if low vitamin D – meta-analysis Sept 2013
- During pregnancy even 400 IU helps metabolic status – RCT July 2013
- 2X more preeclampsia when vitamin D less than 30 ng, etc. - meta-analysis March 2013
- 7X increase in early severe preeclampsia associated with low vitamin D – Aug 2012
- Preeclampsia 3X more likely if low vitamin D at 25th week – April 2012
- Low vitamin D results in severe preeclampsia and low birth weight – Mar 2011
- Women with low vitamin D 4X more likely to have preeclampsia in pregnancy – Nov 2010
- Seasonal variation in pregnancy hypertension is correlated with sunlight intensity -June 2010 no abstract
Background:
The associations between pregnancy hypertensive disorders and common cardiovascular disorders have not been investigated at scale in a contemporaneous population. We aimed to investigate the association between preeclampsia, hypertensive disorders of pregnancy, and subsequent diagnosis of 12 different cardiovascular disorders.
Methods:
We used linked electronic health records from 1997 to 2016 to recreate a UK population-based cohort of 1.3 million women, mean age at delivery 28 years, with nearly 1.9 million completed pregnancies. We used multivariable Cox models to determine the associations between hypertensive disorders of pregnancy, and preeclampsia alone (term and preterm), with 12 cardiovascular disorders in addition to chronic hypertension. We estimated the cumulative incidence of a composite end point of any cardiovascular disorder according to preeclampsia exposure.
Results:
During the 20-year study period, 18 624 incident cardiovascular disorders were observed, 65% of which had occurred in women under 40 years.
Compared to women without hypertension in pregnancy, women who had 1 or more pregnancies affected by preeclampsia had a hazard ratio of
- 1.9 (95% confidence interval 1.53–2.35) for any stroke,
- 1.67 (1.54–1.81) for cardiac atherosclerotic events,
- 1.82 (1.34–2.46) for peripheral events,
- 2.13 (1.64–2.76) for heart failure,
- 1.73 (1.38–2.16) for atrial fibrillation,
- 2.12 (1.49–2.99) for cardiovascular deaths, and
- 4.47 (4.32–4.62) for chronic hypertension
Differences in cumulative incidence curves, according to preeclampsia status, were apparent within 1 year of the first index pregnancy. Similar patterns of association were observed for hypertensive disorders of pregnancy, while preterm preeclampsia conferred slightly further elevated risks.
Conclusions:
Hypertensive disorders of pregnancy, including preeclampsia, have a similar pattern of increased risk across all 12 cardiovascular disorders and chronic hypertension, and the impact was evident soon after pregnancy. Hypertensive disorders of pregnancy should be considered as a natural screening tool for cardiovascular events, enabling cardiovascular risk prevention through national initiatives.