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July 2017

Preeclampsia and Hypertension: Courting a Long While: Time to Make It Official

Author Affiliations
  • 1Cardiovascular Division, Department of Medicine, University of California, San Francisco
  • 2Pregnancy and Cardiac Treatment (PACT) Program, University of California, San Francisco
  • 3The Preterm Birth Initiative (PTBi), University of California, San Francisco
  • 4Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology and Reproductive Sciences, University of California, San Francisco
JAMA Intern Med. 2017;177(7):917-918. doi:10.1001/jamainternmed.2017.1422

Preeclampsia is a multisystem disorder marked by the onset of hypertension after 20 weeks of gestation and new proteinuria or specific organ dysfunction. In the United States, preeclampsia complicates up to 3.8% of all pregnancies and is an important cause of maternal and fetal morbidity and mortality.1 Like acute myocardial infarction, stroke, and malignant forms of hypertension, the acute trigger for the onset of preeclampsia is not fully understood. And much like the acute onset of cardiovascular diseases (CVDs), once preeclampsia is triggered, there is an ensuing cascade of vascular and endothelial dysfunction, inflammation, and coagulation dysfunction that can in turn lead to neurologic, cardiac, pulmonary, renal, and hepatic disease in pregnant women. Delivery is often one of the only means to stop this cascade of events.

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