Arterial stiffness in pregnancies complicated by pre-eclampsia

Abstract

Aims of the study: Pre-eclampsia (PE) is characterized by an altered maternal cardiovascular adaptation to pregnancy and increased cardiovascular risk later on in life. The aim of the current study was to compare arterial stiffness in women with pre-eclampsia and those with normotensive pregnancies. Methods This was a cross sectional study involving 69 normotensive, pregnant women and 54 women with preeclampsia. Maternal wave reflection (augmentation index; AIx) and pulse wave velocity (PWV) of the carotid-radial and carotid-femoral part of the arterial tree were assessed non-invasively using applanation tonometry. Results Compared to normotensive pregnant controls, women with pre-eclampsia had significantly increased AIx (4±13.6% vs 24.3±10.3%, p<0.0001) and current PE was significantly (p<0.0001) and independently associated with increased wave reflection in a model that also included maternal age (p=0.002), heart rate (p<0.0001), gestational age at entry (p= 0.03) and aortic Tr (p<0.0001). The PWV (carotid-femoral and carotid-radial) were significantly higher in women with pre-eclampsia (7.21.2m/sec vs 5.5±0.7m/sec, p<0.0001 and 9.41m/sec vs 7.51.2m/sec, p<0.0001 respectively) and pre-eclampsia was significantly (p<0.0001) and independently associated with increased PWV (carotid-femoral) in a model that also included maternal age (p<0.0001), mean arterial pressure (p<0.0001) and black race (p<0.0001). The results were similar for PWV of the carotid-radial. There was no statistical significant difference in the above parameters between women with early (before 34 weeks of gestation) and late onset PE.

Conclusions Pre-eclampsia is characterized by increased maternal wave reflection and arterial stiffness.