van der Graaf AM, Paauw ND, Toering TJ, Feelisch M, Faas MM, Sutton TR, Minnion M, Lefrandt JD, Scherjon SA, Franx A, Navis G, Lely AT. Impaired sodium-dependent adaptation of arterial stiffness in formerly preeclamptic women: the RETAP-vascular study. Am J Physiol Heart Circ Physiol 310: H1827-H1833, 2016. First published April 8, 2016; doi:10.1152/ajpheart.00010.2016.-Women with a history of preeclampsia have an increased risk for cardiovascular diseases later in life. Persistent vascular alterations in the postpartum period might contribute to this increased risk. The current study assessed arterial stiffness under low sodium (LS) and high sodium (HS) conditions in a well-characterized group of formerly early-onset preeclamptic (fPE) women and formerly pregnant (fHP) women. Eighteen fHP and 18 fPE women were studied at an average of 5 yr after pregnancy on 1 wk of LS (50 mmol Na ϩ /day) and 1 wk of HS (200 mmol Na ϩ /day) intake. Arterial stiffness was measured by pulse-wave analysis (aortic augmentation index, AIx) and carotidfemoral pulse-wave velocity (PWV). Circulating markers of the reninangiotensin aldosterone system (RAAS), extracellular volume (ECV), nitric oxide (NO), and hydrogen sulfide (H2S) were measured in an effort to identify potential mechanistic elements underlying adaptation of arterial stiffness. AIx was significantly lower in fHP women on LS compared with HS while no difference in AIx was apparent in fPE women. PWV remained unchanged upon different sodium loads in either group. Comparable sodium-dependent changes in RAAS, ECV, and NO/H2S were observed in fHP and fPE women. fPE women have an impaired ability to adapt their arterial stiffness in response to changes in sodium intake, independently of blood pressure, RAAS, ECV, and NO/H2S status. The pathways involved in impaired adaptation of arterial stiffness, and its possible contribution to the increased long-term risk for cardiovascular diseases in fPE women, remain to be investigated.Listen to this article's corresponding podcast at http://ajpheart.podbean. com/e/vascular-health-after-preeclampsia/. preeclampsia; formerly preeclamptic women; cardiovascular risk; arterial stiffness; augmentation index; sodium intake
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This study assessed arterial stiffness in healthy formerly preeclamptic (fPE) women under standardized sodium intake and shows that fPE women have a blunted response to adapt their arterial stiffness in response to low sodium intake. This phenomenon might be a first indication of an unfavorable vascular profile in fPE women.PREECLAMPSIA complicates approximately 1-5% of all pregnancies (19) and is characterized by new-onset hypertension and proteinuria or other findings such as new-onset thrombocytopenia, renal insufficiency, neurological complications, liver involvement, and fetal growth restriction during the second half of pregnancy (1). Delivery of the placenta is the only therapeutic solution and results in rapid normalization of the maternal manifestations (46). Despite normalization of hypertension a...