Women with gestational diabetes should be targeted to reduce cardiovascular risk

doi:10.1136/bmj.325.7370.966

BMJ 2002;325:966 ( 26 October )

Letters

Women with gestational diabetes should be targeted to reduce cardiovascular risk

The first 150 words of the full text of this article appear below.

EDITOR $---$ Sattar and Greer discuss the probability that complications in pregnancy may predispose women to vascular and metabolicdisease in later life.¹ The link between pregnancy complicationsand coronary heart disease remains unexplained. We believe thatduring pregnancy the hormonal and other stresses provoke cardiovascularand metabolic abnormalities in susceptible individuals, whichmay recur and become permanent as the patient ages. Many of theseare coronary risk factors; disturbances in glucose metabolism,which underlie the development of gestational diabetes, are agood example.

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An uncomplicated pregnancy is characterised by obvious changes in lipid metabolism early in pregnancy.² These include theformation of small, dense subfractions of low density lipoprotein,an important risk factor for atherosclerosis.³ These are retainedin the arterial intima, are more easily oxidised, and once oxidisedare rapidly taken up into macrophages, creating foam cells andatherosclerotic plaques. The additional effect of pregnancy onlipid metabolism . . . [Full text of this article]

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Pregnancy complications and maternal cardiovascular risk: opportunities for intervention and screening?: Naveed Sattar and Ian A Greer
BMJ 2002 325: 157-160. [Extract] [Full Text] [PDF]