# Preeclampsia to cardiovascular disease: Life course analysis of biomarkers and risk

> **NIH NIH R01** · STANFORD UNIVERSITY · 2021 · $2,278,257

## Abstract

Project Summary: Women who develop preeclampsia during pregnancy are at increased risk for
subsequent atherosclerotic cardiovascular disease (ASCVD), but the biological mechanisms that
mediate this risk have not been elucidated. Whether preeclampsia initiates unique pathophysiologic
processes that lead to ASCVD, or exacerbates an underlying vulnerable vascular state, it provides a
unique opportunity to identify women at increased risk for later ASCVD, and to provide insights into
causal pathways and potential therapeutic targets. We propose that high dimensional biomarker
signatures of preeclampsia will be evident across a woman's life-course, and will be associated with
cardiovascular abnormalities: from pregnancy, through the immediate and late postpartum periods, to
many decades later in women who develop ASCVD. We propose to leverage three large, well-
characterized, ongoing cohorts of women (the Stanford March of Dimes study of pregnancy, the
Danish National Biobank, and the Women's Health Initiative), and to apply cutting edge methods to
gather and analyze high dimensional “omics” data, and ultimately define novel pathophysiologic links
between preeclampsia and ASCVD across the life-course. We will define biomarker signatures of
preeclampsia during pregnancy and early post-partum, based on high dimensional measurements of
the proteome, metabolome, transcriptome, and key cellular components, analyzed using novel
computational methods, and determine their association with cardiovascular abnormalities (Aim 1);
assess preeclampsia biomarker signatures, and their association with subclinical cardiovascular
disease (endothelial dysfunction), five to twenty years after preeclampsia in women free of clinically
evident ASCVD (Aim 2); and identify and validate a preeclampsia biomarker signature that is
associated with development of clinically evident ASCVD (myocardial infarction, ischemic stroke, or
revascularization of the coronary or carotid arteries) in later life (Aim 3). Finally, we will integrate the
data across the life-course to define the evolution of preeclampsia biomarker signatures and their
association with cardiovascular disease, to gain insight into causal pathways, and guide preventive
and therapeutic strategies to reduce the excess risk of ASCVD associated with preeclampsia (Aim 4).
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## Key facts

- **NIH application ID:** 10246433
- **Project number:** 5R01HL139844-04
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Mark A. Hlatky
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $2,278,257
- **Award type:** 5
- **Project period:** 2018-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10246433

## Citation

> US National Institutes of Health, RePORTER application 10246433, Preeclampsia to cardiovascular disease: Life course analysis of biomarkers and risk (5R01HL139844-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10246433. Licensed CC0.

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