Preeclampsia como marcador temprano de riesgo cardiovascular: implicaciones para el seguimiento posparto y la prevención a largo plazo
Resumen
La preeclampsia es un síndrome hipertensivo multisistémico del embarazo asociado con disfunción endotelial, alteración angiogénica, inflamación sistémica y daño microvascular. Aunque tradicionalmente se ha considerado una complicación obstétrica limitada al embarazo y al puerperio, la evidencia actual la reconoce como un marcador temprano de riesgo cardiovascular materno. Las mujeres con antecedente de preeclampsia presentan mayor probabilidad de desarrollar hipertensión arterial crónica, cardiopatía isquémica, evento vascular cerebral, insuficiencia cardiaca, enfermedad renal crónica y mortalidad cardiovascular en etapas posteriores de la vida. Este riesgo es más evidente cuando la preeclampsia fue de inicio temprano, recurrente, con datos de severidad, asociada a parto pretérmino o acompañada de restricción del crecimiento fetal. Desde una perspectiva fisiopatológica, el embarazo puede interpretarse como una prueba de estrés cardiovascular capaz de desenmascarar susceptibilidad vascular y metabólica en mujeres jóvenes aparentemente sanas. Por ello, el antecedente de preeclampsia debe documentarse como un factor relevante dentro de la historia clínica cardiovascular femenina. El periodo posparto representa una ventana crítica para la vigilancia tensional, la evaluación renal y metabólica, la reclasificación del riesgo cardiovascular y el inicio de intervenciones preventivas. Las guías actuales recomiendan una transición estructurada desde la atención obstétrica hacia el seguimiento en primer nivel, medicina interna, cardiología preventiva o nefrología, según el perfil de riesgo. Integrar la historia obstétrica al abordaje cardiovascular permite transformar un evento adverso del embarazo en una oportunidad de prevención primaria a largo plazo.
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World Health Organization. (2011). WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia. World Health Organization. https://apps.who.int/iris/handle/10665/44703
Derechos de autor 2026 Stephany Balboa Solis , Fernando López Díaz, Amy Jocelyn Mengual Ku
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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