Microvascular dysfunction in women with a history of hypertensive disorders of pregnancy: A population-based retrospective cohort study.
cardiovascular disease
endothelial dysfunction
hypertension pregnancy-induced
microcirculation
pre-eclampsia
pregnancy
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
21 Sep 2023
21 Sep 2023
Historique:
revised:
04
08
2023
received:
24
04
2023
accepted:
31
08
2023
medline:
21
9
2023
pubmed:
21
9
2023
entrez:
21
9
2023
Statut:
aheadofprint
Résumé
To evaluate microvascular function in women with previous hypertensive disorders of pregnancy (HDP). Retrospective population-based cohort study. Linköping, Sweden. Women aged 50-65 years, participating in the Swedish CArdioPulmonary bioImage Study (SCAPIS) at one site (Linköping) 2016-18, who underwent microcirculatory assessment (N = 1222). Forearm skin comprehensive microcirculatory assessment was performed with a PeriFlux PF6000 EPOS (Enhanced Perfusion and Oxygen Saturation) system measuring oxygen saturation and total speed resolved perfusion. Obstetric records were reviewed to identify women with previous HDP. Data on cardiovascular risk factors, comorbidities, medication, lifestyle, anthropometric data, and biochemical analyses were obtained from SCAPIS. The microcirculatory data were compared between women with and without previous HDP. Skin microcirculatory oxygen saturation and total speed resolved perfusion at baseline and post-ischaemic peak. Women with previous pre-eclampsia displayed impaired post-ischaemic peak oxygen saturation compared with women with normotensive pregnancies (88%, interquartile range [IQR] 84-89% vs 91%, IQR 87-94%, p = 0.001) 6-30 years after pregnancy. The difference remained after multivariable adjustment (β -2.69, 95% CI -4.93 to -0.45). The findings reveal microvascular dysfunction at long-term follow up in women with previous pre-eclampsia and strengthen the possible role of endothelial dysfunction as a link to the increased risk of cardiovascular disease in women with HDP.
Identifiants
pubmed: 37732494
doi: 10.1111/1471-0528.17665
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Hjärt-Lungfonden
Organisme : Vetenskapsrådet
Organisme : VINNOVA
Informations de copyright
© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
Références
Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice. Hypertension. 2018;72(1):24-43.
Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33(3):130-137.
Wu P, Haththotuwa R, Kwok CS, Babu A, Kotronias RA, Rushton C, et al. Preeclampsia and future cardiovascular health: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2017;10(2):e003497.
Benschop L, Duvekot JJ, Roeters van Lennep JE. Future risk of cardiovascular disease risk factors and events in women after a hypertensive disorder of pregnancy. Heart. 2019;105(16):1273-1278.
Sederholm Lawesson S, Swahn E, Pihlsgård M, Andersson T, Angerås O, Bacsovics Brolin E, et al. Association between history of adverse pregnancy outcomes and coronary artery disease assessed by coronary computed tomography angiography. JAMA. 2023;329(5):393-404.
Romundstad PR, Magnussen EB, Smith GD, Vatten LJ. Hypertension in pregnancy and later cardiovascular risk: common antecedents? Circulation. 2010;122(6):579-584.
Lane-Cordova AD, Khan SS, Grobman WA, Greenland P, Shah SJ. Long-term cardiovascular risks associated with adverse pregnancy outcomes: JACC review topic of the week. J Am Coll Cardiol. 2019;73(16):2106-2116.
Amaral LM, Wallace K, Owens M, LaMarca B. Pathophysiology and current clinical Management of Preeclampsia. Curr Hypertens Rep. 2017;19(8):61.
Rana S, Lemoine E, Granger JP, Karumanchi SA. Preeclampsia: pathophysiology, challenges, and perspectives. Circ Res. 2019;124(7):1094-1112.
Kirollos S, Skilton M, Patel S, Arnott C. A systematic review of vascular structure and function in pre-eclampsia: non-invasive assessment and mechanistic links. Front Cardiovasc Med. 2019;6:166.
Henriques AC, Carvalho FH, Feitosa HN, Macena RH, Mota RM, Alencar JC. Endothelial dysfunction after pregnancy-induced hypertension. Int J Gynaecol Obstet. 2014;124(3):230-234.
Levy BI, Schiffrin EL, Mourad JJ, Agostini D, Vicaut E, Safar ME, et al. Impaired tissue perfusion: a pathology common to hypertension, obesity, and diabetes mellitus. Circulation. 2008;118(9):968-976.
Higashi Y, Noma K, Yoshizumi M, Kihara Y. Endothelial function and oxidative stress in cardiovascular diseases. Circ J. 2009;73(3):411-418.
Higashi Y. Assessment of endothelial function. History, methodological aspects, and clinical perspectives. Int Heart J. 2015;56(2):125-134.
Jonasson H, Fredriksson I, Pettersson A, Larsson M, Strömberg T. Oxygen saturation, red blood cell tissue fraction and speed resolved perfusion - a new optical method for microcirculatory assessment. Microvasc Res. 2015;102:70-77.
Jonasson H, Bergstrand S, Fredriksson I, Larsson M, Östgren CJ, Strömberg T. Post-ischemic skin peak oxygen saturation is associated with cardiovascular risk factors: a Swedish cohort study. Microvasc Res. 2021;140:104284.
Bergstrand S, Morales MA, Coppini G, Larsson M, Strömberg T. The relationship between forearm skin speed-resolved perfusion and oxygen saturation, and finger arterial pulsation amplitudes, as indirect measures of endothelial function. Microcirculation. 2018;25(2):e12422.
Bergström G, Berglund G, Blomberg A, Brandberg J, Engström G, Engvall J, et al. The Swedish CArdioPulmonary BioImage study: objectives and design. J Intern Med. 2015;278(6):645-659.
Gynecology SSoOa. Riktlinjer för hypertonisjukdomar under graviditet, SFOG 2019-10-23. Reviderad 210121. 2021. https://www.sfog.se/media/337263/hypertonisjukdomar-under-graviditet-sfog-2019-10-23-reviderad-210121.pdf
Hellmann M, Roustit M, Cracowski JL. Skin microvascular endothelial function as a biomarker in cardiovascular diseases? Pharmacol Rep. 2015;67(4):803-810.
Jonasson H, Bergstrand S, Fredriksson I, Larsson M, Östgren CJ, Strömberg T. Normative data and the influence of age and sex on microcirculatory function in a middle-aged cohort: results from the SCAPIS study. Am J Physiol Heart Circ Physiol. 2020;318(4):H908-H915.
Powe CE, Levine RJ, Karumanchi SA. Preeclampsia, a disease of the maternal endothelium: the role of antiangiogenic factors and implications for later cardiovascular disease. Circulation. 2011;123(24):2856-2869.
Ives CW, Sinkey R, Rajapreyar I, Tita ATN, Oparil S. Preeclampsia-pathophysiology and clinical presentations: JACC state-of-the-art review. J Am Coll Cardiol. 2020;76(14):1690-1702.
Weissgerber TL, Milic NM, Milin-Lazovic JS, Garovic VD. Impaired flow-mediated dilation before, during, and after preeclampsia: a systematic review and meta-analysis. Hypertension. 2016;67(2):415-423.
Breetveld NM, Ghossein-Doha C, van Neer J, Sengers M, Geerts L, van Kuijk SMJ, et al. Decreased endothelial function and increased subclinical heart failure in women several years after pre-eclampsia. Ultrasound Obstet Gynecol. 2018;52(2):196-204.
Goynumer G, Yucel N, Adali E, Tan T, Baskent E, Karadag C. Vascular risk in women with a history of severe preeclampsia. J Clin Ultrasound. 2013;41(3):145-150.
Hamad RR, Eriksson MJ, Silveira A, Hamsten A, Bremme K. Decreased flow-mediated dilation is present 1 year after a pre-eclamptic pregnancy. J Hypertens. 2007;25(11):2301-2307.
Lopes van Balen VA, Spaan JJ, Cornelis T, Heidema WM, Scholten RR, Spaanderman MEA. Endothelial and kidney function in women with a history of preeclampsia and healthy parous controls: a case control study. Microvasc Res. 2018;116:71-76.
Orabona R, Sciatti E, Vizzardi E, Bonadei I, Valcamonico A, Metra M, et al. Endothelial dysfunction and vascular stiffness in women with previous pregnancy complicated by early or late pre-eclampsia. Ultrasound Obstet Gynecol. 2017;49(1):116-123.
Honigberg MC, Zekavat SM, Raghu VK, Natarajan P. Microvascular outcomes in women with a history of hypertension in pregnancy. Circulation. 2022;145(7):552-554.
Stuart JJ, Tanz LJ, Rimm EB, Spiegelman D, Missmer SA, Mukamal KJ, et al. Cardiovascular risk factors mediate the long-term maternal risk associated with hypertensive disorders of pregnancy. J Am Coll Cardiol. 2022;79(19):1901-1913.
Östlund E, Al-Nashi M, Hamad RR, Larsson A, Eriksson M, Bremme K, et al. Normalized endothelial function but sustained cardiovascular risk profile 11 years following a pregnancy complicated by preeclampsia. Hypertens Res. 2013;36(12):1081-1087.
Alexander Y, Osto E, Schmidt-Trucksäss A, Shechter M, Trifunovic D, Duncker DJ, et al. Endothelial function in cardiovascular medicine: a consensus paper of the European Society of Cardiology Working Groups on atherosclerosis and vascular biology, aorta and peripheral vascular diseases, coronary pathophysiology and microcirculation, and thrombosis. Cardiovasc Res. 2021;117(1):29-42.
Cracowski JL, Roustit M. Human skin microcirculation. Compr Physiol. 2020;10(3):1105-1154.
Spaan JJ, Houben AJ, Musella A, Ekhart T, Spaanderman ME, Peeters LL. Insulin resistance relates to microvascular reactivity 23 years after preeclampsia. Microvasc Res. 2010;80(3):417-421.
Parikh NI, Cnattingius S, Dickman PW, Mittleman MA, Ludvigsson JF, Ingelsson E. Parity and risk of later-life maternal cardiovascular disease. Am Heart J. 2010;159(2):215.e6-221.e6.
Xing Z, Alman AC, Kirby RS. Parity and risk of cardiovascular disease in women over 45 years in the United States: National Health and nutrition examination survey 2007-2018. J Womens Health. 2022;31(10):1459-1466.
O'Kelly AC, Michos ED, Shufelt CL, Vermunt JV, Minissian MB, Quesada O, et al. Pregnancy and reproductive risk factors for cardiovascular disease in women. Circ Res. 2022;130(4):652-672.