Functional and structural vascular biomarkers in women 1 year after a hypertensive disorder of pregnancy

[Display omitted] •1 year after a hypertensive disorder of pregnancy (HDP): adverse pulse wave velocity (PWV) levels.•Not adverse augmentation index, carotid wall thickness, or reactive hyperemia index.•After CVD risk adjustment: no vascular function tests associated with previous HDP.•These tests unlikely to improve cardiovascular risk assessment 1 year after HDP.•Updated preeclampsia definitions did not alter the results. Women with a previous hypertensive disorder of pregnancy (HDP: gestational hypertension and preeclampsia) have increased long-term cardiovascular disease risk. Recent meta-analyses show adverse levels of non-invasive functional and structural cardiovascular risk markers such as pulse wave velocity (PWV), heart-rate adjusted augmentation index (AIx75), carotid intima-media thickness (CIMT), and reactive hyperemia index (RHI) after HDPs, and suggest using these for cardiovascular risk stratification. However, it is not known if a previous HDP predict levels of these markers beyond classical cardiovascular risk factors. Study design and main outcome measures. We assessed PWV, AIx75, CIMT, RHI, classical cardiovascular risk factors, and pregnancy characteristics in 221 women 1 year postpartum (controls: 95, previous HDP: 126). Uni- and multi- variate regression analysis were conducted to assess associations between previous HDP and PWV, AIx75, CIMT or RHI. We adjusted for classical cardiovascular risk factors and pregnancy characteristics. A p-level