Postpartum blood pressure and insulin sensitivity in African-American women with recent preeclampsia.
Pregnancy-induced hypertension and preeclampsia are relatively common in nulliparous, inner-city, African-American, pregnant women and contribute to considerable maternal, fetal, and neonatal morbidity and mortality in that population. Recently, insulin resistance has been related to the development of hypertension in young African-Americans and hyperinsulinemia and elevated insulin-to-glucose ratios, suggesting insulin resistance, have been demonstrated in women with preeclampsia. To investigate whether insulin resistance existed postpartum and, therefore, independently of the pregnant state, the hyperinsulinemic, euglycemic technique was used 3 to 6 months postpartum to assess insulin sensitivity in 10 young, black, primiparous, inner-city women with recent preeclampsia and seven age-, weight- and body-mass-index-matched black women with healthy pregnancies. The age, weight, body-mass index, waist-to-hip ratio, the duration since parturition, and fasting plasma glucose and insulin were similar in the preeclamptic and control groups. During the clamp procedure, the insulin levels and mean diastolic blood pressure and mean arterial pressure were also similar for both groups; however, the mean systolic blood pressure of the preeclamptic group (123 +/- 3 mm Hg) was higher than that of the control group (114 +/- 2 mm Hg) (P < .05). Insulin-stimulated glucose disposal was not different between the preeclamptic (5.6 +/- 0.3 mg/kg/min) and control groups (5.7 +/- 0.7 mg/kg/min). This suggests that the elevation in postpartum systolic blood pressure may reflect a persistent abnormality of blood pressure homeostasis which is not associated with insulin resistance.
Jacober
S J
SJ
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI 48201.
Morris
D A
DA
Sowers
J R
JR
D000293:Adolescent; D000328:Adult; D044383:Black People; D001794:Blood Pressure; D015992:Body Mass Index; D005260:Female; D015309:Glucose Clamp Technique; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D016555:Matched-Pair Analysis; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000208:ethnology* / Q000503:physiopathology*; D011247:Pregnancy; D001741:Black or African American