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Comment & Response
June 16, 2021

A Still-Ignored Cardiovascular Risk Factor—A History of Preeclampsia—Reply

Author Affiliations
  • 1Center for Lipid Metabolomics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 2Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota
  • 3Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 4Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
JAMA Cardiol. 2021;6(9):1098. doi:10.1001/jamacardio.2021.1961

In Reply We agree with Sciatti and Orabona that the described obstetric complications (eg, preeclampsia, hypertensive disorders of pregnancy, gestational diabetes) are associated with higher postpartum cardiovascular risk. The Women’s Health Study (WHS) enrolled participants from 1993 through 1996, and the baseline WHS questionnaire did not include questions on obstetrical complications, precluding a formal analysis in our study,1 as astutely suggested by Sciatti and Orabona. The growing field of cardio-obstetrics has increased focus on the influence of obstetric hemodynamic, valvular, and structural heart changes on postpartum cardiovascular risk, as outlined in the recent scientific statement from the American Heart Association.2 We agree that future work should integrate obstetric history and complications in relation to cardiovascular risk in women. This work could improve risk stratification and guide interventions for better primary cardiovascular prevention, in particular for younger women.

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