Preeclampsia and cardiovascular disease: interconnected paths that enable detection of the subclinical stages of obstetric and cardiovascular diseases

Figures

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  Figure 1. Diagram depicting the stages of preeclampsia integrated to subsequent pregnancies and cardiovascular risk and disease in order to install preventive measures and impact women’s health. Notes: The natural evolution of CVRs to disease is purposefully depicted in gray, as an active preventive strategy should reduce the spontaneous transition. The different gestational stages are framed in blue to highlight the fact that underlying maternal factors enhance impaired vascular remodeling and its alterations. Yellow arrows point to the four windows that permit preventive interventions. In women with a high risk of severe preeclampsia, the addition of L-arginine to the early use of low dose aspirin and calcium supplementation in women with low intake has proven safe and effective, whereas pravastatin is emerging as a potential intervention.62–65 This flowchart complements the one recently proposed by Arabin and Baschat regarding the different levels of clinical care that should be provided at the different stages.14 Abbreviations: CVR, cardiovascular risk; NK, natural killer.