title: Differences in cardiovascular function comparing prior preeclamptics with nulliparous controls.
abstract: OBJECTIVE
  The objective of the current study was to evaluate cardiovascular function; including blood pressure, cardiac output, pulse wave velocity and vascular compliance in nonpregnant nulliparous women compared to women with a history of preterm preeclampsia.
  
  
  METHODS
  This was a case control study. Blood pressure was measured using the Finapres Pro. Baseline cardiac output was determined by echocardiography. Pulse wave velocity was estimated using simultaneous electrocardiographic tracings and ultrasound determined arterial flow waveforms and calculated as estimated distance divided by the time interval between EKG r-wave peak and ultrasound derived peak popliteal artery flow. During volume challenge, 500mL of lactated Ringers solution was infused through an indwelling antecubital catheter over 10min. Cardiac output and blood pressure during and 15min after the infusion were estimated using the Finapres Pro.
  
  
  METHODS
  Indices of arterial stiffness and vascular compliance.
  
  
  RESULTS
  Previous preeclamptics exhibited a significant increase in pulse pressure and cardiac output in response to volume challenge when compared with nulliparous controls. Prior preeclamptics had a strong positive correlation between blood pressure indices (r=0.50-0.68, p⩽0.01) and pulse pressure (r=0.58, P=0.008) with pulse wave velocity that was not evident in control women.
  
  
  CONCLUSIONS
  In women with prior preterm preeclampsia a relationship between blood pressure, intravascular volume and arterial stiffness, is evident in the nonpregnant state and in the absence of hypertension or overt cardiovascular disease. This supports an overarching hypothesis that nonpregnant physiology is an important contributor to pregnancy adaptations.
authors.affiliation: Obstetrics, Gynecology and Reproductive Sciences, 89 Beaumont Ave, University of Vermont, Burlington, VT 05405, United States. Electronic address: ira.bernstein@uvm.edu.
authors.forename: Ira M
authors.initials: IM
authors.lastname: Bernstein
authors.affiliation: Obstetrics, Gynecology and Reproductive Sciences, 89 Beaumont Ave, University of Vermont, Burlington, VT 05405, United States.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Hale
authors.affiliation: Department of Medical Biostatistics, University of Vermont, Burlington, VT 05405, United States.
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Badger
authors.affiliation: Obstetrics, Gynecology and Reproductive Sciences, 89 Beaumont Ave, University of Vermont, Burlington, VT 05405, United States.
authors.forename: Carole A
authors.initials: CA
authors.lastname: McBride
mesh_terms: D000328:Adult; D001794:Blood Pressure; D001808:Blood Vessels / Q000503:physiopathology*; D002302:Cardiac Output; D016022:Case-Control Studies; D003187:Compliance; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness
keywords: Arterial stiffness; Hypertension; Preeclampsia; Pregnancy; Vascular compliance