HEMOSTATIC ABNORMALITIES MAY PREDICT CHRONIC HYPERTENSION AFTER PREECLAMPSIA

Objectives: Preeclampsia is a pregnancy-induced hypertensive disease. About 25-30% of women suffering from this disease will later, while st ill fertile, develop essential hypertension. Study design: Various hem ostatic variables known to increase the risk of cardiovascular complic ations were investigated in 28 women with severe preeclampsia and 14 w ith mild preeclampsia 6-15 months after delivery. Results: High levels of the coagulation inhibitors protein C and total protein S were foun d in the women with severe preeclampsia (p < 0.001). The levels of pro thrombin complex, fibrinogen, plasminogen activator inhibitor-1 were i ncreased in women who had previously had severe preeclampsia as compar ed to those who had had mild preeclampsia (p < 0.01). The levels of th e four markers for thrombin activity (thrombin-antithrombin complex, p rothrombin fragments 1+2, fibrin D-dimers and soluble fibrin) were hig her in the severe preeclampsia group. In 12 women in this group (43%), the levels of three to four variables were higher than the reference ranges (mean +/- 2 SD). In patients with earlier severe or mild preecl ampsia, factor VII antigen was also found to be increased as compared to normal fertile women (p < 0.02). Conclusions: Women with earlier se vere preeclampsia displayed increased levels of coagulation factors an d the main fibrinolytic inhibitor, high levels of which are known to p redict cardiovascular events. This was also reflected by increased lev els of thrombin markers.