Impairment of endothelial function in women with a history of preeclampsia: an indicator of cardiovascular risk

• Published in: American journal of physiology. Heart and circulatory physiology 2004-04, Vol.286 (4), p.H1389-H1393
• Main Authors: Agatisa, Patricia K, Ness, Roberta B, Roberts, James M, Costantino, Joseph P, Kuller, Lewis H, McLaughlin, Margaret K
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Blood Pressure - physiology; Body Mass Index; Cardiovascular Diseases - physiopathology; Endothelium, Vascular - physiopathology; Exercise Test; Female; Forearm - blood supply; Humans; Pre-Eclampsia - physiopathology; Pregnancy; Regional Blood Flow - physiology; Risk Factors; Vascular Resistance - physiology
• ISSN: 0363-6135; 1522-1539
• DOI: 10.1152/ajpheart.00298.2003

1 Magee-Womens Research Institute, 2 Department of Obstetrics and Gynecology and Reproductive Sciences, School of Medicine; and 3 Department of Epidemiology and 4 Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15213 Submitted 1 April 2003 ; accepted in final form 24 November 2003 Preeclampsia is a disorder of pregnancy diagnosed by gestational hypertension and proteinuria. Epidemiological evidence suggests that women who experience preeclampsia are at a greater risk of hypertension and heart disease later in life compared with women who had normal pregnancies. Our objective was to determine whether endothelial function is impaired in postpartum women with a history of preeclampsia in their first pregnancy. We measured forearm blood flow (FBF) by venous occlusion plethysmography in 50 healthy women: 16 with prior preeclampsia, 14 with a prior normotensive pregnancy, and 20 never pregnant controls. The postpartum women participated 6–12 mo after delivery. Heart rate (HR) and blood pressure (BP) were concurrently monitored on the contralateral arm. Hemodynamic variables were assessed at baseline and during a mental stress test known to elicit endothelium-dependent vasodilatation. We found that baseline FBF, HR, systolic BP, and diastolic BP did not significantly differ among the groups, whereas mean arterial pressure in the preeclamptic group was greater than that of the normal pregnancy group ( P = 0.03). Stress-induced FBF (percent change over baseline) was reduced in the preeclamptic group compared with both the normal pregnancy and never pregnant groups ( P = 0.06) and was significantly attenuated compared with women with prior normal pregnancies (91% vs. 147%, P = 0.006). These data demonstrate that women with a history of preeclampsia exhibit impaired endothelial function up to 1 yr postpartum. This observation may explain their increased risk for hypertension and cardiovascular disease. endothelium; cardiovascular disease; risk factors; plethysmography Address for reprint requests and other correspondence: P. K. Agatisa, Cardiovascular Behavioral Medicine Program, Univ. of Pittsburgh, 3811 O'Hara St., Pittsburgh, PA 15213 (E-mail: agatisapk{at}upmc.edu ).