If one reads this medical headline from ACOG to our nations physicians, one would assume/conclude that pre-eclampsia (high blood pressure in pregnancy) itself is responsible for the increase in cardiovascular disease. This is a classic example so common in medical “reporting” in the media. The following is the article title.
Title: Preeclampsia and Cardiovascular Disease in a Large UK Pregnancy Cohort of Linked Electronic Health Records
The title does not at all imply that pre-ecclampsia causes later vascular disease, yet the newly assigned title of the article implies causation. This is important because if people, especially doctors don’t understand the real cause of medical issues, then we can never hope to really tackle the problem. The real message as alluded to in the lower conclusion is the presence of pre-ecclampsia is an early indicator of underlying vascular disease. The real underlying problem is insulin resistance causing both pre-ecclampsia and later cardiovascular disease. The hormones of pregnancy simply uncover and amplify a problem that is lurking beneath the surface. As I have said before, pregnancy is like the ghost of Christmas future from the Christmas Story where the ghost reveals the future to Mr. Scrooge. Pregnancy therefore, gives us a window into the metabolic future of a patient including diabetes and heart disease. Below is the conclusion of the study again not implicating pre-ecclampsia as the cause of the future cardiovascular problems. The real term is association. Associated factors by no means necessarily affect one another, they are simply seen at the same time or in the same patient. This is really why the media should stay out of medical science, including medical media as exemplified here. These subtle semantic differences when repeated 100’s of times can color doctors’ and patients’ beliefs ultimately creating a major negative impact in the propagation of the truth about any disorder. In the end, the patient is the loser in this process.
Conclusion: Hypertensive disorders of pregnancy, including preeclampsia, have a similar pattern of increased risk [of future cardiovascular events] across all 12 cardiovascular disorders and chronic hypertension, and the impact was evident soon after pregnancy. Hypertensive disorders of pregnancy should be considered as a natural screening tool for cardiovascular events, enabling cardiovascular risk prevention through national initiatives.
Michael D. Fox, MD
Jacksonville Center for Reproductive Medicine
Advanced Reproductive Specialists