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

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.