Grant: Operating Grant -PA: Inst of Circulatory and Respiratory Health - Bridge Funding

Pregnancy is a stress test where the development of complications can identify women who are at greater risk of future health complications. As such, this provides a tremendous opportunity to identify women who would benefit by participating in health screening and intervention programs. For instance, large data base studies have demonstrated that pre-eclampsia (PE)- the development of high blood pressure and protein in the urine affecting 5-10% of pregnancies - is associated with an increased risk of early cardiovascular disease (CVD) (eg. heart attack and stroke) and death in these women. Our research group has demonstrated that a large number of these women, by one year after delivery, already have underlying and often undiagnosed cardiovascular risk factors (CVRs); persistence or progression of these CVRs after delivery likely leads to the development of early CVD. Over what time frame this occurs is unknown. We HYPOTHESIZE that the development of PE identifies women with significant underlying CVRs and that long-term follow up will demonstrate the evolution of further CVRs and the development of early CVD. Our LONG-TERM GOAL is to develop guidelines for the timing and nature of follow up/screening and intervention for women affected by PE in order to reduce cardiovascular morbidity and mortality. The OBJECTIVE of the proposal is to determine the evolution of CVRs by serially following classical, novel and innovative physical and biochemical markers of early CVD using the internationally unique group of women who have/have not had a pregnancy complicated by PE that we have established.