title: Preeclampsia and cardiovascular disease risk assessment - Do arterial stiffness and atherosclerosis uncover increased risk ten years after delivery?
abstract: OBJECTIVE
  Epidemiological studies associate preeclampsia with increased risk of premature cardiovascular disease (CVD) later in life. This study aims to make a comprehensive CVD risk assessment comparing women with previous preeclamptic pregnancies to women with previous normotensive pregnancies 10years after index pregnancy.
  
  
  METHODS
  A nested, matched, observational cohort study.
  
  
  METHODS
  Markers of arterial stiffness, aortic pulse wave velocity (aPWV) and augmentation index (AIx-75), and markers of atherosclerosis, carotid intima-media thickness (cIMT) and carotid plaque presence. Traditional CVD risk factors and 10-year and 30-year Framingham CVD risk scores were also assessed.
  
  
  RESULTS
  Women were included from April 2014 to October 2014 at a tertiary referral hospital in Denmark. Twenty-one exposed women with a history of preeclampsia and 21 unexposed with a history of normotensive pregnancies were included. Ten years after delivery, significantly more exposed women suffered from hypertension and received antihypertensive treatment and significantly more fulfilled the hypertension-definition at screening. Previously preeclamptic women also tended to have more unfavorable CVD risk estimates. The Framingham risk scores seemed to extend the unfavorable CVD risk. The exposed women tended to have a higher aPWV compared to unexposed women, (P=0.057). No differences were shown in the other examined arteriosclerotic or atherosclerotic variables.
  
  
  CONCLUSIONS
  Ten years after delivery, we found increased risk of hypertension and trend toward unfavorable CVD risk profile in 40-year-old previously preeclamptic women. However, arterial stiffness and atherosclerosis did not uncover any additional CVD risk information at this time point.
authors.affiliation: Clinical Research Unit, Randers Regional Hospital, Skovlyvej 1, 8930 Randers NO, Denmark; Institute of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark. Electronic address: marticis@rm.dk.
authors.forename: Martin
authors.initials: M
authors.lastname: Christensen
authors.affiliation: Department of Oncology, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C, Denmark. Electronic address: camikron@rm.dk.
authors.forename: Camilla Skovhus
authors.initials: CS
authors.lastname: Kronborg
authors.affiliation: Department of Cardio-Thoracic and Vascular Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark. Electronic address: eldrup@clin.au.dk.
authors.forename: Nikolaj
authors.initials: N
authors.lastname: Eldrup
authors.affiliation: Diagnostic Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600 Silkeborg, Denmark; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C, Denmark. Electronic address: niklas.rossen@rm.dk.
authors.forename: Niklas Blach
authors.initials: NB
authors.lastname: Rossen
authors.affiliation: Department of Gynecology and Obstetrics, Horsens Regional Hospital, Sundsvej 30, 8700 Horsens, Denmark. Electronic address: ubk@dadlnet.dk.
authors.forename: Ulla Breth
authors.initials: UB
authors.lastname: Knudsen
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000175:diagnosis / Q000209:etiology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology; D058226:Plaque, Atherosclerotic; D011225:Pre-Eclampsia; D011247:Pregnancy; D063177:Pulse Wave Analysis; D018570:Risk Assessment; D012307:Risk Factors; D059289:Vascular Stiffness
keywords: Arterial stiffness; Atherosclerosis; Cardiovascular disease risk; Framingham risk score; Preeclampsia