Epidemiology of vascular diseases

Epidemiology has been a key tool in the discovery of modifiable risk factors that cause vascular diseases and has allowed us to monitor the impact of interventions on public health. Although there are long-term declines in the rates of traditional vascular diseases in the Western world, there are an increasing number of people living with chronic diseases such as vascular dementia and heart failure. In addition, there are challenges presented by socioeconomic, cultural, and demographic inequalities in vascular health care that might benefit from ongoing precision medicine research to target the right treatment to the right patients at the right time. Cardiovascular diseases are still the leading cause of death worldwide, and researchers need to raise awareness and improve management of risk factors for vascular disease within the global context

Cardiovascular Sequels During and After Preeclampsia

Preeclampsia is a pregnancy-specific disorder complicating 2%-8% of pregnancies worldwide and characterized by de novo development of hypertension and proteinuria. Current understanding of the pathophysiology of preeclampsia is limited. A main feature is disrupted spiral artery remodeling in the placenta, which restricts the blood flow to the placenta, which in turn leads to decreased uteroplacental perfusion. Impaired blood flow through the placenta might result in fetal growth restriction and secretion of several factors by the placenta-mainly pro-inflammatory cytokines and anti-angiogenic factors-which spread into the maternal circulation, leading to endothelial dysfunction, which subsequently results in disrupted maternal hemodynamics. To date, no treatment options are available apart from termination of pregnancy. Despite normalization of the maternal vascular disturbances after birth, it has become apparent that formerly preeclamptic women experience an increased risk to develop cardiovascular and kidney disease later in life. One well-accepted concept is that the development of preeclampsia is an indicator of maternal susceptibility to develop future cardiovascular conditions, although the increased risk might also be the result of organ damage caused during preeclampsia. Given the associations between preeclampsia and long-term complications, preeclampsia is acknowledged as woman-specific risk factor for cardiovascular disease. Current research focuses on finding effective screening and prevention strategies for the reduction of cardiovascular disease in women with a history of preeclampsia