Hypertensive disorders and diabetic pregnancy

The striking increase in the prevalence of obesity, diabetes mellitus (DM), hypertension, and cardiovascular disease in the last two decades ¹ has led to the concept of the metabolic syndrome. ² Also termed syndrome X, ³ insulin resistance syndrome, ⁴ and the deadly quartet, ⁵ metabolic syndrome is characterized by a constellation of well-documented risk factors for cardiovascular disease, namely, glucose intolerance, insulin resistance, central obesity, dyslipidemia, and hypertension, that co-occur in individuals at a higher rate than expected by chance. Extensive research has still not completely elucidated the precise cause of the syndrome, although some strong positions have been taken. Nevertheless, it is widely recognized that a combination of genetic predisposition and environmental factors, particularly those associated with socioeconomic status, is involved. The environmental factors include both postnatal life habits and nutrition and—no less important—intrauterine conditions. Indeed, there is plentiful evidence linking low birth weight due to fetal growth restriction (FGR) with an increased risk of vascular disease in later adult life. ⁶