Precision test for precision medicine: Opportunities, challenges and perspectives regarding pre-eclampsia as an intervention window for future cardiovascular disease

Xin Zhou, Jian Min Niu, Wen Jie Ji, Zhuoli Zhang, Peizhong P. Wang, Xue Feng B. Ling, Yu Ming Li*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

Hypertensive disorders of pregnancy (HDP) comprise a spectrum of syndromes that range in severity from gestational hypertension and pre-eclamplsia (PE) to eclampsia, as well as chronic hypertension and chronic hypertension with superimposed PE. HDP occur in 2% to 10% of pregnant women worldwide, and impose a substantial burden on maternal and fetal/infant health. Cardiovascular disease (CVD) is the leading cause of death in women. The high prevalence of non-obstructive coronary artery disease and the lack of an efficient diagnostic workup make the identification of CVD in women challenging. Accumulating evidence suggests that a previous history of PE is consistently associated with future CVD risk. Moreover, PE as a maladaptation to pregnancy-induced hemodynamic and metabolic stress may also be regarded as a “precision” testing result that predicts future cardiovascular risk. Therefore, the development of PE provides a tremendous, early opportunity that may lead to changes in maternal and infant future well-being. However, the underlying pathogenesis of PE is not precise, which warrants precision medicine-based approaches to establish a more precise definition and reclassification. In this review, we proposed a stage-specific, PE-targeted algorithm, which may provide novel hypotheses that bridge the gap between Big Datagenerating approaches and clinical translational research in terms of PE prediction and prevention, clinical treatment, and long-term CVD management.

Original languageEnglish (US)
Pages (from-to)1920-1934
Number of pages15
JournalAmerican Journal of Translational Research
Volume8
Issue number5
StatePublished - 2016

Keywords

  • Cardiac stress test
  • Cardiovascular risk
  • Hypertensive disorders in pregnancy
  • Pre-eclampsia
  • Precision medicine

ASJC Scopus subject areas

  • Molecular Medicine
  • Clinical Biochemistry
  • Cancer Research

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