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Bryan Williams is to be congratulated on focusing interest on this
important topic. However, in the review (BMJ 2011;342:d1104) there was no
mention of the role that pregnancy has in terms of highlighting risk in
women of child bearing age. In women who develop pre-eclampsia, there is a
3.7 relative risk of developing hypertension later in life; the risk being
greatest in those who develop pre-eclampsia at earlier gestations (1).
As a Professor of Maternal and Fetal Medicine, I'm aware that such
women should be highlighted for high blood pressure & dyslipidaemia
screening with additional advice relating to lifestyle change and
potential pharmacoprophylaxis after and outside pregnancy. However, it is
something we achieve rarely. Such surveillance in primary care may lead to
reductions in premature morbidity and mortality.
Yours sincerely,
Mark Kilby
Professor of Maternal & Fetal Medicine,
School of Clinical & Experimental Medicine, College of Medical &
Dental Sciences, University of Birmingham, B15 2TT.
Clinical Lead in Fetal Medicine,
Fetal Medicine Centre, Birmingham Women's Foundation Trust, Edgbaston,
Birmingham, B15 2TG.
Reference
1. Bellamy L, Casas JP, Hingorani AD, Williams DJ. Pre-eclampsia and risk
of cardiovascular disease and cancer in later life: a systematic review
and metaanalysis. BMJ 2007;335:974e7
Competing interests:
No competing interests
08 March 2011
Mark D. Kilby
Professor of Fetal Medicine
University of Birmingham & Birmingham Women's Foundation Trust
Pre-eclampsia as a marker of hypertension risk
Dear Sir/Madam,
Bryan Williams is to be congratulated on focusing interest on this
important topic. However, in the review (BMJ 2011;342:d1104) there was no
mention of the role that pregnancy has in terms of highlighting risk in
women of child bearing age. In women who develop pre-eclampsia, there is a
3.7 relative risk of developing hypertension later in life; the risk being
greatest in those who develop pre-eclampsia at earlier gestations (1).
As a Professor of Maternal and Fetal Medicine, I'm aware that such
women should be highlighted for high blood pressure & dyslipidaemia
screening with additional advice relating to lifestyle change and
potential pharmacoprophylaxis after and outside pregnancy. However, it is
something we achieve rarely. Such surveillance in primary care may lead to
reductions in premature morbidity and mortality.
Yours sincerely,
Mark Kilby
Professor of Maternal & Fetal Medicine,
School of Clinical & Experimental Medicine, College of Medical &
Dental Sciences, University of Birmingham, B15 2TT.
Clinical Lead in Fetal Medicine,
Fetal Medicine Centre, Birmingham Women's Foundation Trust, Edgbaston,
Birmingham, B15 2TG.
Reference
1. Bellamy L, Casas JP, Hingorani AD, Williams DJ. Pre-eclampsia and risk
of cardiovascular disease and cancer in later life: a systematic review
and metaanalysis. BMJ 2007;335:974e7
Competing interests: No competing interests