TY - JOUR
T1 - Evaluating the role of statins in prevention of preeclampsia
T2 - deeper insights into maternal cardiometabolic changes
AU - Rao, Shiavax J.
AU - Martin, Seth Shay
AU - Lawson, Shari M.
AU - Hailu, Tigist
AU - Davis, Dorothy M.
AU - Nasir, Khurram
AU - Cainzos-Achirica, Miguel
AU - Blumenthal, Roger S.
AU - Sharma, Garima
N1 - Funding Information:
GS is supported by the Blumenthal Scholarship in Preventive Cardiology.
Publisher Copyright:
© 2022
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Pregnant women with gestational hypertension and/or preeclampsia, have derangements of atherogenic lipids in early pregnancy. Changes in maternal lipids can promote atherogenesis through endothelial injury. These alterations in serum lipid levels have been linked to adverse pregnancy outcomes and maternal morbidity and mortality. Several recent studies have examined maternal atherogenic profiles in early pregnancy, and their relationships to preeclampsia and other adverse pregnancy outcomes. Given their effects on reduction of endothelial dysfunction, inflammation, and plaque stabilization, statin therapies may have utility in prevention and treatment of preeclampsia. We sought to investigate this further by examining the association between dyslipidemia and preeclampsia, as well as the potential role of statins in the prevention of preeclampsia. We discuss the pathophysiology of placental dysfunction in preeclampsia, the safety profile of statins in pregnancy, and evaluate the potential utility of statins in pregnancy, based on recent studies, specifically for women at high risk of developing preeclampsia. The lipid-lowering, immunomodulatory, anti-inflammatory, and pleiotropic effects of statins may make them promising candidates for the prevention and treatment of preeclampsia. However, it is important to note that the clinical use of statin therapy to prevent preeclampsia has no support from current research and is not justified. A reasonably large trial of pravastatin reported no effect on preeclampsia but used limited dosing with the intervention performed only in women at high-risk of term preeclampsia. Further research in randomized controlled trials extending the parameters of statin dosing is needed to help determine if preeclampsia can be effectively prevented.
AB - Pregnant women with gestational hypertension and/or preeclampsia, have derangements of atherogenic lipids in early pregnancy. Changes in maternal lipids can promote atherogenesis through endothelial injury. These alterations in serum lipid levels have been linked to adverse pregnancy outcomes and maternal morbidity and mortality. Several recent studies have examined maternal atherogenic profiles in early pregnancy, and their relationships to preeclampsia and other adverse pregnancy outcomes. Given their effects on reduction of endothelial dysfunction, inflammation, and plaque stabilization, statin therapies may have utility in prevention and treatment of preeclampsia. We sought to investigate this further by examining the association between dyslipidemia and preeclampsia, as well as the potential role of statins in the prevention of preeclampsia. We discuss the pathophysiology of placental dysfunction in preeclampsia, the safety profile of statins in pregnancy, and evaluate the potential utility of statins in pregnancy, based on recent studies, specifically for women at high risk of developing preeclampsia. The lipid-lowering, immunomodulatory, anti-inflammatory, and pleiotropic effects of statins may make them promising candidates for the prevention and treatment of preeclampsia. However, it is important to note that the clinical use of statin therapy to prevent preeclampsia has no support from current research and is not justified. A reasonably large trial of pravastatin reported no effect on preeclampsia but used limited dosing with the intervention performed only in women at high-risk of term preeclampsia. Further research in randomized controlled trials extending the parameters of statin dosing is needed to help determine if preeclampsia can be effectively prevented.
KW - Cholesterol
KW - Dyslipidemia
KW - Hydroxymethylglutaryl-coenzyme A reductase inhibitors
KW - Preeclampsia
KW - Pregnancy
KW - Prevention
KW - Statins
UR - http://www.scopus.com/inward/record.url?scp=85131561952&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85131561952&partnerID=8YFLogxK
U2 - 10.1016/j.jacl.2022.04.007
DO - 10.1016/j.jacl.2022.04.007
M3 - Review article
C2 - 35668023
AN - SCOPUS:85131561952
VL - 16
SP - 403
EP - 416
JO - Journal of Clinical Lipidology
JF - Journal of Clinical Lipidology
SN - 1933-2874
IS - 4
ER -