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Stroke vs. Preeclampsia: Dangerous Liaisons of Hypertension and Pregnancy

Stroke during pregnancy and preeclampsia are two distinct but interrelated medical conditions, sharing a common denominator—blood control failure. Along with cardiovascular diseases, diabetes, dyslipidemia, and hypercoagulability, hypertension is undoubtedly a major risk factor associated with strok...

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Autores principales: Lackovic, Milan, Nikolic, Dejan, Jankovic, Milena, Rovcanin, Marija, Mihajlovic, Sladjana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10608338/
https://www.ncbi.nlm.nih.gov/pubmed/37893425
http://dx.doi.org/10.3390/medicina59101707
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author Lackovic, Milan
Nikolic, Dejan
Jankovic, Milena
Rovcanin, Marija
Mihajlovic, Sladjana
author_facet Lackovic, Milan
Nikolic, Dejan
Jankovic, Milena
Rovcanin, Marija
Mihajlovic, Sladjana
author_sort Lackovic, Milan
collection PubMed
description Stroke during pregnancy and preeclampsia are two distinct but interrelated medical conditions, sharing a common denominator—blood control failure. Along with cardiovascular diseases, diabetes, dyslipidemia, and hypercoagulability, hypertension is undoubtedly a major risk factor associated with stroke. Even though men have higher age-specific stroke rates, women are facing higher life-long stroke risk, primarily due to longer life expectancy. Sex hormones, especially estrogen and testosterone, seem to play a key link in the chain of blood pressure control differences between the genders. Women affected with stroke are more susceptible to experience some atypical stroke manifestations, which might eventually lead to delayed diagnosis establishment, and result in higher morbidity and mortality rates in the population of women. Preeclampsia is a part of hypertensive disorder of pregnancy spectrum, and it is common knowledge that women with a positive history of preeclampsia are at increased stroke risk during their lifetime. Preeclampsia and stroke display similar pathophysiological patterns, including hypertension, endothelial dysfunction, dyslipidemia, hypercoagulability, and cerebral vasomotor reactivity abnormalities. High-risk pregnancies carrying the burden of hypertensive disorder of pregnancy have up to a six-fold higher chance of suffering from stroke. Resemblance shared between placental and cerebral vascular changes, adaptations, and sophisticated auto-regulatory mechanisms are not merely coincidental, but they reflect distinctive and complex cardiovascular performances occurring in the maternal circulatory system during pregnancy. Placental and cerebral malperfusion appears to be in the midline of both of these conditions; placental malperfusion eventually leads to preeclampsia, and cerebral to stoke. Suboptimal performances of the cardiovascular system are proposed as a primary cause of uteroplacental malperfusion. Placental dysfunction is therefore designated as a secondary condition, initiated by the primary disturbances of the cardiovascular system, rather than an immunological disorder associated with abnormal trophoblast invasion. In most cases, with properly and timely applied measures of prevention, stroke is predictable, and preeclampsia is a controllable condition. Understanding the differences between preeclampsia and stroke in pregnancy is vital for healthcare providers to enhance their clinical decision-making strategies, improve patient care, and promote positive maternal and pregnancy outcomes. Management approaches for preeclampsia and stroke require a multidisciplinary approach involving obstetricians, neurologists, and other healthcare professionals.
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spelling pubmed-106083382023-10-28 Stroke vs. Preeclampsia: Dangerous Liaisons of Hypertension and Pregnancy Lackovic, Milan Nikolic, Dejan Jankovic, Milena Rovcanin, Marija Mihajlovic, Sladjana Medicina (Kaunas) Review Stroke during pregnancy and preeclampsia are two distinct but interrelated medical conditions, sharing a common denominator—blood control failure. Along with cardiovascular diseases, diabetes, dyslipidemia, and hypercoagulability, hypertension is undoubtedly a major risk factor associated with stroke. Even though men have higher age-specific stroke rates, women are facing higher life-long stroke risk, primarily due to longer life expectancy. Sex hormones, especially estrogen and testosterone, seem to play a key link in the chain of blood pressure control differences between the genders. Women affected with stroke are more susceptible to experience some atypical stroke manifestations, which might eventually lead to delayed diagnosis establishment, and result in higher morbidity and mortality rates in the population of women. Preeclampsia is a part of hypertensive disorder of pregnancy spectrum, and it is common knowledge that women with a positive history of preeclampsia are at increased stroke risk during their lifetime. Preeclampsia and stroke display similar pathophysiological patterns, including hypertension, endothelial dysfunction, dyslipidemia, hypercoagulability, and cerebral vasomotor reactivity abnormalities. High-risk pregnancies carrying the burden of hypertensive disorder of pregnancy have up to a six-fold higher chance of suffering from stroke. Resemblance shared between placental and cerebral vascular changes, adaptations, and sophisticated auto-regulatory mechanisms are not merely coincidental, but they reflect distinctive and complex cardiovascular performances occurring in the maternal circulatory system during pregnancy. Placental and cerebral malperfusion appears to be in the midline of both of these conditions; placental malperfusion eventually leads to preeclampsia, and cerebral to stoke. Suboptimal performances of the cardiovascular system are proposed as a primary cause of uteroplacental malperfusion. Placental dysfunction is therefore designated as a secondary condition, initiated by the primary disturbances of the cardiovascular system, rather than an immunological disorder associated with abnormal trophoblast invasion. In most cases, with properly and timely applied measures of prevention, stroke is predictable, and preeclampsia is a controllable condition. Understanding the differences between preeclampsia and stroke in pregnancy is vital for healthcare providers to enhance their clinical decision-making strategies, improve patient care, and promote positive maternal and pregnancy outcomes. Management approaches for preeclampsia and stroke require a multidisciplinary approach involving obstetricians, neurologists, and other healthcare professionals. MDPI 2023-09-24 /pmc/articles/PMC10608338/ /pubmed/37893425 http://dx.doi.org/10.3390/medicina59101707 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Lackovic, Milan
Nikolic, Dejan
Jankovic, Milena
Rovcanin, Marija
Mihajlovic, Sladjana
Stroke vs. Preeclampsia: Dangerous Liaisons of Hypertension and Pregnancy
title Stroke vs. Preeclampsia: Dangerous Liaisons of Hypertension and Pregnancy
title_full Stroke vs. Preeclampsia: Dangerous Liaisons of Hypertension and Pregnancy
title_fullStr Stroke vs. Preeclampsia: Dangerous Liaisons of Hypertension and Pregnancy
title_full_unstemmed Stroke vs. Preeclampsia: Dangerous Liaisons of Hypertension and Pregnancy
title_short Stroke vs. Preeclampsia: Dangerous Liaisons of Hypertension and Pregnancy
title_sort stroke vs. preeclampsia: dangerous liaisons of hypertension and pregnancy
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10608338/
https://www.ncbi.nlm.nih.gov/pubmed/37893425
http://dx.doi.org/10.3390/medicina59101707
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