Cardiovascular System During the Postpartum State in Women With a History of Preeclampsia

In subjects with previous preeclampsia, differences in cardiovascular and/or blood biochemical parameters are present in the nonpregnant state, and a simultaneous assessment of multiple derived indices better differentiates between women with or without previous preeclampsia. We examined 18 previous preeclamptic and 50 previous uncomplicated pregnancies, approximate to 16 months postpartum. Cardiovascular assessment included the following: (1) systemic hemodynamics and mechanics (Doppler echocardiography, tonometry, and oscillometric sphygmomanometry); (2) endothelial function (plethysmography); (3) left ventricular properties (echocardiography); and (4) blood biochemical analyses. Compared to women with previous uncomplicated pregnancies, previous preeclamptics had higher mean (80 +/- 1 versus 86 +/- 3 mm Hg; P=0.04) and diastolic (64 +/- 1 versus 68 +/- 2 mm Hg; P=0.04) pressures and total vascular resistance (1562 +/- 37 versus 1784 +/- 114 dyne . s/cm(5); P=0.03). Systolic blood pressure, arterial compliance, and left ventricular properties were not different. Although heart-to-femoral pulse wave velocity was not different, heart-to-brachial pulse wave velocity tended to be faster in previous preeclamptics (374 +/- 8 versus 404 +/- 20 cm/s; P=0.06). Stress-induced increase in forearm blood flow was less in previous preeclamptics (245%+/- 21% versus 136%+/- 22%; P=0.01), indicating impaired endothelial function. No significant differences were observed in markers of endothelial activation, dyslipidemia, or oxidative stress; previous preeclamptics tended to have higher glucose level (58.7 +/- 1.9 versus 95 +/- 5.2 mg/dL; P=0.06). Logistic regression analysis indicated that a simultaneous evaluation of multiple derived indices better discriminated between the 2 groups. The differences in the previous preeclamptic group are in directions known to be associated with greater cardiovascular disease risk later in life. (Hypertension. 2011;58:57-62.). Online Data Supplement