Preeclampsia Increases Risk of Decreased Retinal Microvascular Density, Cardiac Health Later in Life

Article: Damage from preeclampsia may be seen decades later in the eyes
Source: American Heart Association
Published: February 14, 2022

Hypertensive disorders of pregnancy (HDPs) are associated with long-term cardiovascular diseases, including atherosclerosis and heart failure. In HDPs, excess circulating antiangiogenic factors induce maternal systemic endothelial and microvascular dysfunction, researchers explain, which manifest clinically as hypertension and proteinuria in late pregnancy. Although associations between hypertensive disorders of pregnancy and microvascular dysfunction, as well as associations between retinal microvasculature and ocular and systemic health, have been well-studied, whether hypertensive disorders of pregnancy could be detected in retinal vascular health had not been explored. Researchers publishing in the journal Circulation  of the American Heart Association looked at U.K. Biobank data of 19,182 parous women 54 years of age on average, 281 of whom had a history of hypertensive disorders of pregnancy. The authors report that the women with a history of preeclampsia (n=66) continued to have elevated protein in the urine, a sign of kidney damage; these women also had lower retinal vascular density, which is linked to various systemic diseases as well as decreased ocular health. The researchers note that, after adjustment for various demographic factors, the association was not observed in HDPs broadly, such as in gestational hypertension. A nephrology and hypertension expert from Mayo Clinic, who was not part of the study, comments, "They have shown that decreased retinal vascular density is specific for preeclampsia. Therefore, this research may be very important in terms of stratifying different hypertensive disorders of pregnancy and their specific effect on cardiovascular disease." Additional studies would add to our understanding of the timing of microvascular changes as they pertain to preeclampsia and later heart disease; however, the study in question is significant in revealing yet another systemic condition that could benefit from early and nuanced detection via retinal imaging.

My rating of this study: ⭐⭐⭐

Honigberg MC, Zekavat SM, Raghu VK, et al. "Microvascular Outcomes in Women With a History of Hypertension in Pregnancy." Circulation.  145:552–554. 14 February 2022. https://doi.org/10.1161/CIRCULATIONAHA.121.057139