Journal
ATHEROSCLEROSIS
Volume 229, Issue 1, Pages 212-216Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.atherosclerosis.2013.04.012
Keywords
Hypertension in pregnancy; Peripheral vascular disease; Ankle-brachial index
Funding
- National Heart, Lung, and Blood Institute
- NIH [U01HL054481, U01HL054471, U01HL054512, U01HL054498]
- Eunice Kennedy Shriver National Institute of Child Health & Human Development [K08HD051714]
- National Institute on Aging [P-50 AG44170]
- Society for Womens Health Research (SWHR) ISIS Network award
- Office of Women's Health Research [K12HD065987]
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Background: An ankle-brachial index (ABI) (the ratio of ankle to brachial artery systolic blood pressure) value <= 0.9 identifies patients with peripheral arterial disease (PAD) and elevated cardiovascular event risk. This study examined whether women with a history of hypertension in pregnancy are more likely to have an ABI <= 0.9 decades after pregnancy. Methods and results: ABI was measured in nulliparous women (n = 144), and women with a history of normotensive (n = 1272) or hypertensive (n = 281) pregnancies who participated in the Genetic Epidemiology Network of Arteriopathy (GENOA) study [non-Hispanic white (39%) and black (61%) women, 60 (mean) +/- 10 (SD) years of age]. Relationships between PAD and pregnancy history were examined by logistic regression. Compared to women with a history of normotensive pregnancy, women with a history of hypertensive pregnancy had greater odds of PAD (1.61 (odds ratio); 1.04-2.49 (95% confidence interval), p = 0.03, adjusted for age, race, height and heart rate). Additional adjustment for ever smoking, hypertension, diabetes, dyslipidemia, a family history of hypertension or coronary heart disease, body mass index and education did not attenuate this relationship (1.63; 1.02-2.62, p = 0.04). PAD risk did not differ between women with a history of normotensive pregnancy and nulliparous women (1.06; 0.52-2.14, p = 0.87). Conclusions: Hypertension in pregnancy is an independent risk factor for PAD decades after pregnancy after adjusting for race, age, height, heart rate, ever smoking, hypertension, diabetes, dyslipidemia, a family history of hypertension or coronary heart disease, body mass index and education. (C) 2013 Published by Elsevier Ireland Ltd.
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