Pulse Wave Velocity as a Tool for Cardiometabolic Risk Stratification in Individuals With Hypertensive Disorders of Pregnancy and Increased BMI

Obesity is one of the most prevalent risk factors for hypertensive disorders of pregnancy (HDP); however, the role of pre-pregnancy cardiometabolic health in the development of these conditions is not well understood. Carotid-femoral pulse wave velocity (PWV) is an established measure of arterial stiffness and cardiovascular health and is validated in pregnancy. Our objective was to examine the obesity-related changes in PWV in pregnant individuals with and without HDP. Overall, 87 individuals with singleton pregnancies were recruited and classified into 2 groups: cases (HDP: including pre-existing/chronic hypertension, gestational hypertension, preeclampsia, or intrauterine growth restriction; n = 39) and normotensive controls (no HDP or intrauterine growth restriction; n = 48). Patient data, including BMI, were collected from patient charts. Measurements of PWV were performed weekly until discharge or delivery (gestational age 24–37 weeks) and placental growth factor (PlGF) was measured at routine blood draws. PWV did not significantly change over gestation for either group. Cases had significantly increased PWV and decreased PlGF compared to normotensive controls. An elevated BMI was associated with higher PWV in both cases and controls. Once grouped based on BMI, PWV was only significantly higher in cases with a BMI ≥25 kg/m2 compared to controls, whereas PlGF was less affected by BMI. As PWV increased, PlGF decreased; however, after controlling for BMI, there was no relationship between PWV and PlGF. PWV measurements in early pregnancy may be useful as an additional independent marker to PlGF for risk-stratifying for HDP, especially in individuals with increased BMI. L’obésité est un des facteurs de risque les plus répandus des troubles hypertensifs de la grossesse (THG); cependant, le rôle de la santé cardiométabolique avant la grossesse dans le développement de ces troubles n’est pas bien compris. La vitesse de l’onde de pouls carotido-fémorale (VOPcf) est une mesure reconnue de la rigidité artérielle et de la santé cardiovasculaire et dont l’utilisation pendant la grossesse a été validée. Notre objectif était d’examiner les changements de la VOPcf liés à l’obésité chez les femmes enceintes avec ou sans THG. Au total, 87 personnes ayant une grossesse monofœtale ont été recrutées et classées en deux groupes : THG (hypertension préexistante ou chronique, hypertension gestationnelle, pré-éclampsie ou retard de croissance intra-utérin [RCIU]; n = 39) et