The association between preeclampsia and arterial stiffness

Abstract

A systematic review and meta-analysis was conducted using MEDLINE, EMBASE, and the Cochrane Library to investigate the association between preeclampsia and arterial stiffness. Twenty-three relevant studies were included. A significant increase in all arterial stiffness indices combined was observed in women with preeclampsia vs. women with normotensive pregnancies [standardized mean difference 1.62, 95% confidence interval (CI) 0.73-2.50]; carotid-femoral pulse wave velocity (cfPWV) and augmentation index (AIx) were also significantly increased (weighted mean difference, WMDcfPWV 1.04, 95% CI 0.34-1.74; WMDAIx 15.10, 95% CI 5.08-25.11), whereas carotid-radial PWV (crPWV) increase did not reach significance (WMDcrPWV 0.99, 95% CI -0.07 to 2.05). Significant increases in arterial stiffness measurements were noted in women with preeclampsia compared with those with gestational hypertension. Arterial stiffness measurements may also be useful in predicting preeclampsia and may play a role in the increased risk of future cardiovascular complications seen in women with a history of preeclampsia.

Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk

“…Preeclampsia aggregates in families,6 and new evidence suggests that fetal genetic variants near FLT1 (fms‐related tyrosine kinase 1), a gene involved in angiogenesis, may contribute to risk 7, 8. Precise causes of preeclampsia are still unknown, but contributors are impaired angiogenesis,9 systemic endothelial dysfunction,10 and decreased vascular compliance resulting in impaired accommodation of the volume expansion required for healthy gestation 11. Importantly, preeclampsia involves multisystem dysfunction.…”

Preeclampsia as a Form of Type 5 Cardiorenal Syndrome: An Underrecognized Entity in Women’s Cardiovascular Health

“…A recent meta-analysis showed a significant increase in all arterial stiffness indices in women with preeclampsia versus women with normotensive pregnancies (standardized mean difference 1.62, 95% confidence interval [CI] 0.73-2.50) [43]. Arterial stiffness measurements may also be useful in predicting preeclampsia and may play a role in the increased risk of future cardiovascular complications seen in women with a history of preeclampsia [43,44].…”

Preeclampsia and Vascular Function: A Window to Future Cardiovascular Disease Risk

“…56,57 While increased PWV readings have also been observed in preeclamptic compared to normal pregnancy, 49,56 the increases are much less remarkable and often do not reach statistical significance. 48,58 Maternal vasculature may be altered even after delivery of the fetus and placenta. Arterial stiffness indices have been found to be elevated from a few weeks 49 up to 3 years postpartum.…”