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(Hypertension. 2003;42:39.)
© 2003 American Heart Association, Inc.

Scientific Contributions

Classic and Novel Risk Factor Parameters in Women With a History of Preeclampsia

Naveed Sattar; Jane Ramsay; Lynne Crawford; Helen Cheyne; Ian A. Greer

From the University Departments of Pathological Biochemistry (N.S., L.C.) and Obstetrics and Gynaecology (J.R., H.C., I.A.G.), Glasgow Royal Infirmary University NHS Trust, Glasgow, Scotland.

Correspondence to Prof Ian Greer, Department of Obstetrics and Gynaecology, University of Glasgow, Glasgow Royal Infirmary, Glasgow G31 2ER UK. E-mail I.A.Greer{at}clinmed.gla.ac.uk

Epidemiological studies demonstrate a relation between preeclampsia (PE) and an increased risk of maternal coronary heart disease (CHD) in later life. However, there are few data available to explain any underlying mechanism. We recruited 40 primigravid women with a history of proteinuric PE delivering between 1975 and 1985 and 40 controls, matched as a group for time of index pregnancy, smoking, and current body mass index to assess classic (lipids, blood pressure) and novel (adhesion molecules, insulin, leptin) risk factor pathways. Women with a history of PE had higher diastolic blood pressure compared with controls (83 vs 76 mm Hg, P<0.05), but there were no significant differences in fasting lipoprotein concentrations (P>0.20). However, concentrations of vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 (ICAM-1) in particular were higher in the PE group by 14% (P=0.038) and 44% (P=0.002), respectively. The cases also demonstrated a tendency toward higher fasting insulin (P=0.08) concentrations and had higher glycosylated hemoglobin levels (P=0.004). Leptin concentrations were not significantly elevated. Interestingly, significantly more of the women with history of PE were classified as menopausal (37.55% vs 17.5%, P=0.045). The differences in ICAM-1 concentration persisted (P=0.010) after adjustment for potential confounders, including hormonal use/menopausal status, antihypertensive or lipid-lowering therapy, and social class. We conclude that classic risk factors alone cannot fully explain the elevated CHD risk in women with a history of PE. Rather markedly elevated ICAM-1 concentrations and specific but subtle features of the metabolic syndrome (glucose, blood pressure) are likely to be involved.

Key Words: pregnancy • endothelium • insulin resistance • lipoproteins • coronary disease

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