title: Markers of cardiovascular disease risk after hypertension in pregnancy.
abstract: OBJECTIVE
  Women with a history of preeclampsia or gestational hypertension have an increased risk of cardiovascular disease. Underlying cardiovascular risk factors, persistent endothelial dysfunction or sympathetic overactivity may contribute to this risk. We studied markers of cardiovascular disease risk in nonpregnant women with a history of hypertension in pregnancy.
  
  
  METHODS
  Women with a history of preeclampsia (n = 39), gestational hypertension (n = 27) and normal pregnancies (n = 35) were studied 2-12 years after delivery. Laboratory measures included plasma fasting lipids, glucose, insulin, creatinine and urinary albumin-to-creatinine ratio. Blood pressure was measured by 24-h ambulatory blood pressure monitoring, endothelial function by flow-mediated dilatation and sympathetic activity by both head-up tilt test and cold pressor test, including the response of the circulating renin-angiotensin system to tilt testing.
  
  
  RESULTS
  Compared with women who had previous normal pregnancies, women with a history of preeclampsia or gestational hypertension have higher ambulatory blood pressure, BMI and relative insulin resistance. Glomerular filtration rate, albumin-to-creatinine ratio, endothelial function and sympathetic activity was similar among the three groups.
  
  
  CONCLUSIONS
  Women with a history of preeclampsia or gestational hypertension have features of the metabolic syndrome which are presumably present already before pregnancy, predisposing them to hypertensive disorders of pregnancy and later cardiovascular risk. In this study, we found no evidence for early renal damage, endothelial dysfunction or sympathetic overactivity in the postpartum state.
authors.affiliation: Departments of Medicine and Renal Medicine, St George Hospital, University of New South Wales, Kogarah, New South Wales, Australia. g.mangos@unsw.edu.au
authors.forename: George J
authors.initials: GJ
authors.lastname: Mangos
authors.forename: Julia J
authors.initials: JJ
authors.lastname: Spaan
authors.forename: Saiyini
authors.initials: S
authors.lastname: Pirabhahar
authors.forename: Mark A
authors.initials: MA
authors.lastname: Brown
mesh_terms: D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood* / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D015415:Biomarkers