Abstract 49: Blood Pressure is Correlated with Arterial Stiffness in Previous Preterm Preeclamptics
Blood pressure (BP) and arterial stiffness are known to be correlated and have independent value in assessing risk for future cardiovascular disease. The objective of the current study was to evaluate the relationship between arterial stiffness, as measured by pulse wave velocity (PWV), and BP, in nulliparous women (CTL) as compared to women with a history of preterm preeclampsia (PE). Twenty-eight nulliparous women and 19 PEs were evaluated during the follicular phase of the menstrual cycle. There were no differences in age: CTL: 30.9 ± 0.9 vs. PE: 31.3 ± 1.1 yrs, p = 0.78. BMI was significantly lower in CTL: 24.4 ± 1.1 vs. PE: 28.5 ± 1.6 kg/m2, p = 0.02. Time interval from delivery to evaluation in PE was 2.46 ± 0.29 yrs. PWV was measured using simultaneous electrocardiographic tracings and ultrasound determined arterial flow waveforms and calculated as the estimated distance divided by the time interval between EKG r-wave peak and ultrasound derived peak popliteal artery flow. Beat to beat BPs were measured in the seated position using the Finapres Pro and averaged over one minute. The data are expressed as mean ± SE. P < 0.05 accepted for significance. MAP was significantly lower in CTLs than in PEs: 87.7 ± 1.4 vs PE: 94.4 ± 2.4, p = 0.02. There was no difference in PWV between CTL and PE: CTL: 2.51 ± 0.05, PE: 2.52 ± 0.06, p = 0.88. Pulse pressure was significantly correlated with PWV in PEs, but not in CTLs, CTL: r = 0.26, p = 0.18, PE: r = 0.54, p = 0.02. Systolic BP was significantly correlated in both CTL and PE with PWV: CTL: r = 0.43, p = 0.02, PE: r = 0.53, p = 0.02. There was a trend for a significant positive correlation between diastolic BP and PWV in the PE group, but not in the CTL: r = 0.11, p = 0.57, PE: r = 0.44, p = 0.06. The same trend existed in the PE for MAP and PWV: CTL: r = 0.27, p = 0.17, PE: 0.44, p = 0.06. For women who have had previous PE, a significant relationship exists between BP and arterial stiffness, while women who have not had a pregnancy do not exhibit this relationship. Pregnancy likely unmasks subclinical cardiovascular derangement resulting in PE, and persisting years beyond delivery. Our observations suggest that for women who have had prior PE evaluating the relationship between arterial stiffness and BP may be more informative for cardiovascular risk than assessing PWV alone.
- © 2012 by American Heart Association, Inc.