Preeclampsia in healthy women and endothelial dysfunction 10 years later

Objective Recent studies have shown that women with a history of preeclampsia have an increased risk of cardiovascular disease. The present study investigated cardiovascular risk factors 10 years after preeclampsia in previously healthy women. Study Design Based on data from the Medical Birth Registry in Norway, we selected 182 women with and 180 women without preeclampsia in their first pregnancy 9-11 years earlier, excluding women with cardiovascular or renal disease before pregnancy. Flow-mediated dilation of the brachial artery (FMD) and intima-media thickness (IMT) of the carotid artery were measured and blood samples were drawn. Blood samples were analyzed for cardiovascular risk markers and for circulating markers of endothelial function. Results A total of 89 women with previous preeclampsia and 69 women without preeclampsia participated, an overall attendance rate of 44%. FMD and IMT were similar between groups. Women with previous preeclampsia more often had urate and soluble fms-like tyrosine kinase values above the 75th percentile (odds ratio [OR], 2.4; P = .03, and OR, 2.4; P = .04, respectively) and high-density lipoprotein cholesterol values below the 25th percentile (OR, 2.3; P = .04). Women with preeclampsia with low birthweight offspring were associated with asymmetric dimethylarginine, L-arginine, and homoarginine above the 75th percentile, whereas the women with preeclampsia with normal-weight offspring were associated with urate and soluble fms-like tyrosine kinase above the 75th percentile. Conclusion Preeclampsia was not associated with impaired FMD or increased IMT 10 years after pregnancy in previously healthy women, but preeclampsia was associated with changes in circulating markers that might represent early endothelial dysfunction.