Preeclampsia and increased risk of cardiovascular disease: a practice guide for providers

Abstract

Cardiovascular disease (CVD) is the leading cause of death among women, however this disease is preventable and treatable. Extant evidence has established that women with a history of preeclampsia are at an increased risk for developing CVD later in life, and yet preeclampsia is under-recognized as a risk factor for CVD. This is due to a knowledge gap amongst healthcare providers, and subsequently providers are not adequately educating their patients with a history of preeclampsia about their CVD risk and reducing this risk. There are no specific guidelines regarding long-term care or screening for CVD in women with a history of preeclampsia, so a guideline needs to be developed to assist providers in caring for this high-risk population. The first aim of this project is to develop a guideline for providers to use in practice while caring for women with a history of preeclampsia, and the second aim is to enhance providers' knowledge of the link between a history of preeclampsia and increased CVD risk later in life so they can provide improved, evidence-based care. This project used a pre-survey, educational content with dissemination of two practice guidelines in different formats and a patient educational handout, and post-survey approach. The project targeted healthcare providers who care for women with a history of preeclampsia at a small rural hospital. Providers who participated in this project did have knowledge of the link between preeclampsia and increased CVD later in life, but were not applying this knowledge to their practice, as they neither took a thorough pregnancy history from their patients in regards to preeclampsia nor provided counseling to women with a history of preeclampsia about their increased risk of CVD. Providers who reviewed the guideline presented in this project found it helpful and had or planned to implement a practice change because of the guideline. The practice guideline developed was an effective tool to help the providers in this project implement evidence-based care into their practice, and the patient handout was an additional resource they could use to educate their patients with a history of preeclampsia.