Preeclampsia and cardiovascular disease risk assessment – Do arterial stiffness and atherosclerosis uncover increased risk ten years after delivery?

• Ten years after preeclampsia, traditional CVD risk assessment seems to be valuable.
• Blood pressure needs to be assessed in 40-year old previously preeclamptic women.
• Arterial stiffness and atherosclerosis markers did not uncover increased CVD risk.

ObjectivesEpidemiological studies associate preeclampsia with increased risk of premature cardiovascular disease (CVD) later in life. This study aims to make a comprehensive CVD risk assessment comparing women with previous preeclamptic pregnancies to women with previous normotensive pregnancies 10 years after index pregnancy.Study designA nested, matched, observational cohort study.Main outcome measuresMarkers of arterial stiffness, aortic pulse wave velocity (aPWV) and augmentation index (AIx-75), and markers of atherosclerosis, carotid intima-media thickness (cIMT) and carotid plaque presence. Traditional CVD risk factors and 10-year and 30-year Framingham CVD risk scores were also assessed.ResultsWomen were included from April 2014 to October 2014 at a tertiary referral hospital in Denmark. Twenty-one exposed women with a history of preeclampsia and 21 unexposed with a history of normotensive pregnancies were included. Ten years after delivery, significantly more exposed women suffered from hypertension and received antihypertensive treatment and significantly more fulfilled the hypertension-definition at screening. Previously preeclamptic women also tended to have more unfavorable CVD risk estimates. The Framingham risk scores seemed to extend the unfavorable CVD risk. The exposed women tended to have a higher aPWV compared to unexposed women, (P = 0.057). No differences were shown in the other examined arteriosclerotic or atherosclerotic variables.ConclusionsTen years after delivery, we found increased risk of hypertension and trend toward unfavorable CVD risk profile in 40-year-old previously preeclamptic women. However, arterial stiffness and atherosclerosis did not uncover any additional CVD risk information at this time point.