Parallel decrease in arterial distensibility and in endothelium-dependent dilatation in young women with a history of pre-eclampsia.
Pre-eclampsia not only complicates 5 to 8% of pregnancies but also increases the risk of maternal cardiovascular disease and mortality later in life. We analyzed three different aspects of arterial function (pulse wave velocity, augmentation index, and flow-mediated dilatation), in 55 nonpregnant, normotensive women (18-33 years old) according to their gestational history: 15 nulliparous, 20 with a previous normotensive, and 20 formerly pre-eclamptic pregnancy. Former pre-eclamptic women showed a significantly higher augmentation index and pulse wave velocity (P < 0.001 and P < 0.05, respectively) and lower flow-mediated dilatation (p = 0.01) compared to control groups. In contrast, sublingual nitroglycerine elicited a comparable vasodilatory response in the three groups. The augmentation index correlated significantly with pulse wave velocity and flow-mediated dilatation (R = 0.28 and R = -0.32, respectively, P < 0.05 for both). No significant correlations were observed between augmentation index or flow-mediated dilatation with age, body mass index (BMI), brachial blood pressure, heart rate, or metabolic parameters (plasma cholesterol, glucose, insulin, or insulin resistance). Birth weight maintained a significantly inverse correlation with the augmentation index (R = -0.51, p < 0.002) but not with flow-mediated dilatation. Our findings revealed a parallel decrease in arterial distensibility and endothelium-dependent dilatation in women with a history of pre-eclampsia compared to nulliparous women and women with a previous normal pregnancy. A high augmentation index was the most consistent alteration associated with a history of pre-eclampsia. The study supports the current view that the generalized arterial dysfunction associated with pre-eclampsia persists subclinically after delivery.
Pàez
Olga
O
Secciòn de Hipertensiòn Arterial, Servicio de Cardiologia, Hospital Santojanni, Buenos Aires, Argentina. oblpaez@hotmail.com
Alfie
José
J
Gorosito
Marta
M
Puleio
Pablo
P
de Maria
Marcelo
M
Prieto
Noemì
N
Majul
Claudio
C
D000293:Adolescent; D000328:Adult; D001724:Birth Weight / Q000502:physiology; D001783:Blood Flow Velocity / Q000502:physiology; D002339:Carotid Arteries / Q000503:physiopathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D005996:Nitroglycerin / Q000494:pharmacology; D010298:Parity / Q000502:physiology; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology*; D014665:Vasodilator Agents / Q000494:pharmacology; D055815:Young Adult
D014665:Vasodilator Agents; D005996:Nitroglycerin