Pregnancy as the prodrome to vascular dysfunction and cardiovascular risk

ABSTRACT In previously apparently healthy women, glucose intolerance and high blood pressure during pregnancy are common and frequently occur together. This article reviews the role of these

gestational disorders as markers of vascular dysfunction and its pathophysiology. Mechanisms include alterations to function of large arteries and resistance vessels and to capillary blood

flow. Much of the vessel pathology is seen in both gestational diabetes and hypertension. In women who have had transient diabetes during pregnancy and later redeveloped overt diabetes,

cardiovascular risk is already elevated nearly fourfold before diagnosis, which is almost as high as the average risk after a clinical diagnosis of diabetes is made. This key finding

suggests that vascular risk in such women is at least partly independent of overt hyperglycemia. KEY POINTS * Gestational diabetes and gestational hypertensive disorders might have common

underlying pathophysiological mechanisms * Gestational diabetes and gestational hypertensive disorders are associated with vascular dysfunction demonstrable in small and large vessels *

Long-term follow-up studies seem not to have been done in women with gestational diabetes, although studies in women with gestational hypertensive disorders have demonstrated raised

cardiovascular risk * Early intervention in women with gestational diabetes or hypertension, as well as better definition of their risk, could help to prevent future cardiovascular disease

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support SIMILAR CONTENT BEING VIEWED BY OTHERS LONG-TERM MICROVASCULAR AND BLOOD PRESSURE DYSREGULATION AFTER PREECLAMPSIA Article 02 April 2025 PREGNANCY AND CARDIOVASCULAR DISEASE Article

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for help in preparation of the manuscript. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * British Heart Foundation Fellow and JK Cruickshank is Professor of Cardiovascular Medicine and

Clinical Epidemiology at Manchester Royal Infirmary, UK M Banerjee & JK Cruickshank Authors * M Banerjee View author publications You can also search for this author inPubMed Google

Scholar * JK Cruickshank View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to M Banerjee. ETHICS DECLARATIONS COMPETING

INTERESTS The authors declare no competing financial interests. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Banerjee, M., Cruickshank, J. Pregnancy

as the prodrome to vascular dysfunction and cardiovascular risk. _Nat Rev Cardiol_ 3, 596–603 (2006). https://doi.org/10.1038/ncpcardio0683 Download citation * Received: 23 December 2005 *

Accepted: 30 June 2006 * Issue Date: November 2006 * DOI: https://doi.org/10.1038/ncpcardio0683 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content:

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