Journal
ATHEROSCLEROSIS
Volume 229, Issue 1, Pages 234-239Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.atherosclerosis.2013.04.020
Keywords
Carotid intima-media thickness; Preeclampsia; Pregnancy; Cardiovascular disease; Hypertension
Funding
- Heart and Stroke Foundation (HSF), Ontario, Canada [NA6337]
- Canadian Institutes of Health Research (CIHR), Ottawa, Canada
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Objective: We assessed for subclinical atherosclerosis using carotid intima-media thickness (CIMT) among women with and without a remote history of preeclampsia. Secondarily, we contrasted cardiovascular risk factors and electrocardiography between both groups. Women with a history of preeclampsia are at higher risk of future cardiovascular disease (CVD). The degree to which this is mediated by atherosclerosis is less understood, especially after several decades. Methods: We performed a nested cohort study comprising 109 women with a remote history of preeclampsia 1:2 matched to 218 women with an uncomplicated pregnancy. After a median of 20 years since the index pregnancy, we measured blood pressure, height, weight, waist and hip circumference, and performed an oral 75 g glucose tolerance test (OGTT), fasting lipids, electrocardiography, albumin: creatinine ratio (ACR) and CIMT among all participants. Results: While women with and without preeclampsia had similar family histories of CVD, those with preeclampsia had a higher rate of chronic hypertension (32% versus 10%, p < 0.0001), greater waist (p = 0.008) and hip circumferences (p = 0.001). No differences were seen on in OGTT, lipid or ACR measures. Average maximum CIMT was similar among those with versus without preeclampsia (0.831 mm versus 0.817, p = 0.38), and preeclampsia was not a significant predictor of CIMT in a multiple linear regression model (p = 0.63), despite more electrocardiograms compatible with coronary disease. Conclusion: Two decades after delivery, women with a remote history of preeclampsia had more CVD risk factors than women with unaffected pregnancies, but this was not reflected in a difference in CIMT. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
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