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Atherosclerosis. 2013 Jul;229(1):234-9. doi: 10.1016/j.atherosclerosis.2013.04.020. Epub 2013 Apr 25.

Measures of cardiovascular risk and subclinical atherosclerosis in a cohort of women with a remote history of preeclampsia.

Author information

1
Departments of Obstetrics and Gynecology (Division of Maternal-Fetal Medicine) and Radiology, McMaster University, Hamilton, Ontario, Canada. mcdonals@mcmaster.ca

Abstract

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.

[Indexed for MEDLINE]

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