Departments of Obstetrics and Gynecology (Division of Maternal-Fetal Medicine) and Radiology, McMaster University, Hamilton, Ontario, Canada.
Atherosclerosis. 2013 Jul;229(1):234-9. doi: 10.1016/j.atherosclerosis.2013.04.020. Epub 2013 Apr 25.
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.
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.
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.
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.
我们通过颈动脉内膜中层厚度（CIMT）评估有和无子痫前期史的女性亚临床动脉粥样硬化情况。其次，我们对比了两组的心血管危险因素和心电图。有子痫前期病史的女性未来患心血管疾病（CVD）的风险更高。但这种风险在几十年后有多大程度是由动脉粥样硬化介导的，目前了解甚少。
我们进行了一项巢式队列研究，纳入了 109 名有子痫前期史的女性（1:2 与 218 名无并发症妊娠的女性匹配）。在指数妊娠后中位数为 20 年时，我们测量了所有参与者的血压、身高、体重、腰围和臀围，并进行了口服 75 g 葡萄糖耐量试验（OGTT）、空腹血脂、心电图、白蛋白/肌酐比（ACR）和 CIMT。
虽然有子痫前期和无子痫前期的女性有相似的 CVD 家族史，但前者的慢性高血压发生率更高（32%对 10%，p<0.0001），腰围（p=0.008）和臀围更大（p=0.001）。OGTT、血脂或 ACR 测量值无差异。有子痫前期和无子痫前期的女性平均最大 CIMT 相似（0.831mm 对 0.817mm，p=0.38），且子痫前期在多线性回归模型中不是 CIMT 的显著预测因素（p=0.63），尽管有更多心电图与冠心病相符。
分娩后 20 年，有子痫前期史的女性比无妊娠并发症的女性有更多的 CVD 危险因素，但这并没有反映在 CIMT 上的差异。
