Persistence of cardiovascular risk factors in women with previous preeclampsia: a long-term follow-up study.
BACKGROUND
Preeclampsia is a cardiovascular (CV) disease risk factor, and lifestyle modifications are recommended. It was suggested that preeclampsia may increase the prevalence of various CV disease risk factors such as metabolic syndrome, hypertension, insulin resistance, microalbuminuria, and endothelial dysfunction, among others. Here, we investigate the role of serum uric acid in preeclampsia in the development of CV complications.


METHODS
This was an observational case-control study that compared women with history of preeclampsia (n = 25) with age-matched controls with uncomplicated pregnancies (n = 20) who were followed for at least 5 years. Measurements included clinical and ambulatory blood pressure monitoring, ultrasound-measured flow-mediated dilatation (FMD), microalbuminuria, carotid intima-media thickness (CIMT) and serum uric acid, as well as clinical and demographic features. Cardiovascular disease risk factors were compared in women with and without previous preeclampsia.


RESULTS
At the time of index gestation, preeclamptic women had higher serum uric acid values (4.36 ± 0.61 vs 2.27 ± 0.38 mg/dL, P < 0.001). Five years after pregnancy, the patients who had preeclampsia were more likely to have hypertension and had higher serum uric acid levels, higher microalbuminuria and CIMT levels, and lower FMD values than did the patients who did not have preeclampsia. The 2 groups were similar with regard to various ambulatory blood pressure parameters. Univariate associates of FMD were history of preeclampsia and the current hypertension status. Microalbuminuria correlated with gestational uric acid levels (coefficient of correlation of 0.40, P = 0.01 for FMD and coefficient of correlation of 0.37, P = 0.01 for CIMT, respectively).


CONCLUSIONS
Preeclampsia might be a risk factor for the development of cardiovascular risk factors at least 5 years after index pregnancy. Serum uric acid and microalbuminuria may be mechanistic mediators of heightened risk, along with impaired endothelial function in preeclampsia.
From the *Department of Medicine, Kayseri Training and Research Hospital, Kayseri; †Department of Medicine, Division of Nephrology, Sakarya University Training and Research Hospital, Sakarya; Departments of ‡Cardiology, and §Gynecology, Kayseri Training and Research Hospital, Kayseri; ∥Department of Nephrology, Konya Numune State Hospital, Konya, Turkey; ¶Nephrology Clinic, Dialysis and Renal Transplant Center, C.I. Parhon University Hospital and Grigore T. Popa University of Medicine, Iasi, Romania; **Division of Renal Diseases and Hypertension, University of Colorado, Denver, CO; and ††Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey.
Fatma
F
Aykas
Yalcin
Y
Solak
Abdulsamet
A
Erden
Kadir
K
Bulut
Selcuk
S
Dogan
Bahadr
B
Sarli
Gokhan
G
Acmaz
Baris
B
Afsar
Dimitrie
D
Siriopol
Adrian
A
Covic
Shailendra
S
Sharma
Richard J
RJ
Johnson
Mehmet
M
Kanbay
D000328:Adult; D000419:Albuminuria / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D059168:Carotid Intima-Media Thickness / Q000639:trends; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D011247:Pregnancy; D012307:Risk Factors; D013997:Time Factors; D014527:Uric Acid / Q000097:blood; D055815:Young Adult
D014527:Uric Acid