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Persistence of Cardiovascular Risk Factors in Women With Previous Preeclampsia
  1. Fatma Aykas, MD*,
  2. Yalcin Solak, MD,
  3. Abdulsamet Erden, MD*,
  4. Kadir Bulut, MD*,
  5. Selcuk Dogan, MD,
  6. Bahadır Sarli, MD,
  7. Gokhan Acmaz, MD§,
  8. Baris Afsar, MD,
  9. Dimitrie Siriopol, MD,
  10. Adrian Covic, MD,
  11. Shailendra Sharma, MD**,
  12. Richard J. Johnson, MD**,
  13. Mehmet Kanbay, MD††
  1. From the *Department of Medicine, Kayseri Training and Research Hospital, Kayseri; †Department of Medicine, Division of Nephrology, Sakarya University Training and Research Hospital, Sakarya; Departments of ‡Cardiology, and §Gynecology, Kayseri Training and Research Hospital, Kayseri; ∥Department of Nephrology, Konya Numune State Hospital, Konya, Turkey; ¶Nephrology Clinic, Dialysis and Renal Transplant Center, C.I. Parhon University Hospital and Grigore T. Popa University of Medicine, Iasi, Romania; **Division of Renal Diseases and Hypertension, University of Colorado, Denver, CO; and ††Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey.
  1. Received September 24, 2014, and in revised form January 21, 2015.
  2. Accepted for publication January 22, 2015.
  3. Reprints: Mehmet Kanbay, MD, Department of Medicine, Division of Nephrology, Koc University School of Medicine, 03490, Sariyer, Istanbul, Turkey. E-mail: drkanbay{at}yahoo.com; mkanbay{at}ku.edu.tr.
  4. Conflict of interest: Dr. Johnson is an inventor on several patent and patent applications related to lowering uric acid in the treatment of metabolic and renal diseases that have been licensed to XORT Therapeutics. The other authors state that they have no proprietary interest in the products named in this article.

A Long-term Follow-up Study

Abstract

Background Preeclampsia is a cardiovascular (CV) disease risk factor, and lifestyle modifications are recommended. It was suggested that preeclampsia may increase the prevalence of various CV disease risk factors such as metabolic syndrome, hypertension, insulin resistance, microalbuminuria, and endothelial dysfunction, among others. Here, we investigate the role of serum uric acid in preeclampsia in the development of CV complications.

Materials and Methods This was an observational case-control study that compared women with history of preeclampsia (n = 25) with age-matched controls with uncomplicated pregnancies (n = 20) who were followed for at least 5 years. Measurements included clinical and ambulatory blood pressure monitoring, ultrasound-measured flow-mediated dilatation (FMD), microalbuminuria, carotid intima-media thickness (CIMT) and serum uric acid, as well as clinical and demographic features. Cardiovascular disease risk factors were compared in women with and without previous preeclampsia.

Results At the time of index gestation, preeclamptic women had higher serum uric acid values (4.36 ± 0.61 vs 2.27 ± 0.38 mg/dL, P < 0.001). Five years after pregnancy, the patients who had preeclampsia were more likely to have hypertension and had higher serum uric acid levels, higher microalbuminuria and CIMT levels, and lower FMD values than did the patients who did not have preeclampsia. The 2 groups were similar with regard to various ambulatory blood pressure parameters. Univariate associates of FMD were history of preeclampsia and the current hypertension status. Microalbuminuria correlated with gestational uric acid levels (coefficient of correlation of 0.40, P = 0.01 for FMD and coefficient of correlation of 0.37, P = 0.01 for CIMT, respectively).

Conclusions Preeclampsia might be a risk factor for the development of cardiovascular risk factors at least 5 years after index pregnancy. Serum uric acid and microalbuminuria may be mechanistic mediators of heightened risk, along with impaired endothelial function in preeclampsia.

Key Words
  • preeclampsia
  • cardiovascular disease
  • risk factor
  • endothelial dysfunction
  • uric acid
  • microalbuminuria

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