title: Cardiovascular risk factors in healthy women with previous gestational hypertension.
abstract: BACKGROUND
  Epidemiological studies indicate that gestational hypertension (Gh) during pregnancy is associated with increased risk of cardiovascular disease in later life. However, it is unclear whether particular metabolic and hemodynamic characteristics are related to this risk.
  
  
  OBJECTIVE
  The objective of this study was to investigate endothelial function and carbohydrate and lipid metabolism in healthy, normotensive women with previous pregnancy complicated by Gh.
  
  
  METHODS
  Brachial artery flow-mediated dilatation (FMD; endothelium dependent) and nitroglycerin-induced dilatation (endothelium independent) were measured in 15 subjects with previous Gh and in 15 controls with previous normal pregnancies. Lipid panel, glucose, insulin, homocysteine, and androgens were also measured.
  
  
  RESULTS
  FMD was significantly reduced in women with previous Gh compared with controls (P < 0.0001), whereas nitroglycerin-induced dilatation was comparable in both groups. Gh women showed increased fasting insulin (P = 0.011), insulin resistance measured by homeostasis model assessment (P = 0.018), free fatty acids (P = 0.0018), and testosterone (P = 0.0012) and decreased high-density lipoprotein cholesterol (P = 0.0017) compared with controls. Across all subjects, FMD showed a strong independent negative correlation with testosterone and homeostasis model assessment and a positive correlation with high-density lipoprotein cholesterol (r = -0.60, P = 0.0003; r = -0.43, P = 0.016; and r = 0.58, P = 0.0005, respectively).
  
  
  CONCLUSIONS
  Endothelial dysfunction and early alteration of carbohydrate and lipid metabolism are present in otherwise healthy women with previous Gh. These abnormalities along with a relative hyperandrogenism could explain, at least in part, the increased risk for cardiovascular disease in later life in these women.
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, Via Servilio IV 4, 00178 Rome, Italy. giancarlo.paradisi@tin.it
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Paradisi
authors.forename: Arabella
authors.initials: A
authors.lastname: Biaggi
authors.forename: Rosa
authors.initials: R
authors.lastname: Savone
authors.forename: Francesca
authors.initials: F
authors.lastname: Ianniello
authors.forename: Claudia
authors.initials: C
authors.lastname: Tomei
authors.forename: Leonardo
authors.initials: L
authors.lastname: Caforio
authors.forename: Alessandro
authors.initials: A
authors.lastname: Caruso
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition / Q000502:physiology; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000502:physiology; D050260:Carbohydrate Metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D004730:Endothelium, Vascular / Q000502:physiology; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D050356:Lipid Metabolism / Q000502:physiology; D005996:Nitroglycerin; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology*; D012307:Risk Factors; D014463:Ultrasonography; D014664:Vasodilation / Q000502:physiology; D014665:Vasodilator Agents
chemical_list: D001786:Blood Glucose; D007328:Insulin; D014665:Vasodilator Agents; D005996:Nitroglycerin