Prevention of Vascular Dysfunction after Preeclampsia: A Potential Long-Term Outcome Measure and an Emerging Goal for Treatment

Figure 2

Theoretical timelines of impairment of endothelial function and development of cardiovascular disease following preeclamptic pregnancy. (1) In the normal individuals there is a gradual age-related reduction in endothelial function, which can be exacerbated by the presence of cardiovascular risk factors and associates with the future risk of clinical cardiovascular disease. (2) Women who experience preeclamptic pregnancies are known to have impaired endothelial function during pregnancy and up to 3 years following an affected pregnancy. It is possible that these women begin life with normal endothelial function, which is acutely impaired during a preeclamptic pregnancy. This followed by ongoing age-related decreases in endothelial function may relate to the increased incidence of cardiovascular disease in these individuals. (3) Alternatively, women who develop preeclampsia may have primary endothelial dysfunction which both puts them at risk of preeclampsia, this may then be exacerbated by the preeclamptic pregnancy (solid line), or simply persist (dotted line), in either case leading to higher incidence of cardiovascular disease.