The EVA (Early Vascular Aging) Study: Association of Central Obesity With Worse Arterial Health After Preeclampsia
Background Women with preeclampsia have a higher risk of cardiovascular disease. This is partly explained by the worse arterial health after preeclampsia. Central obesity (CO) is a risk factor for both preeclampsia and cardiovascular disease. Whether CO contributes to further worsening of arterial h...
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| Vydáno v: | Journal of the American Heart Association Ročník 12; číslo 21; s. e031136 |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
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England
John Wiley and Sons Inc
07.11.2023
Wiley |
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| ISSN: | 2047-9980, 2047-9980 |
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| Abstract | Background Women with preeclampsia have a higher risk of cardiovascular disease. This is partly explained by the worse arterial health after preeclampsia. Central obesity (CO) is a risk factor for both preeclampsia and cardiovascular disease. Whether CO contributes to further worsening of arterial health after preeclampsia remains unclear. Our objective was to evaluate the effect of CO and previous preeclampsia on arterial hemodynamics. Methods and Results We studied 40 women with previous preeclampsia (<6 years) and 40 age-matched controls with previous normotensive pregnancy in the same timeframe. We estimated arterial hemodynamics with validated techniques combining applanation tonometry and echocardiography. CO was defined as a waist-to-hip ratio ≥0.85. Differences in arterial hemodynamics across the 3 groups (preeclampsia with CO, preeclampsia without CO, and controls) were assessed with multivariable linear regression models adjusted for potential confounders. Twenty-six (65%) of the participants with preeclampsia had CO compared with 18 (45%) controls. Mean waist-to-hip ratio in patients with preeclampsia with CO, those with preeclampsia and no CO, and controls was 0.94±0.05, 0.80±0.04, and 0.83±0.07, respectively. In multivariable analyses, women with preeclampsia and CO had higher central blood pressure, arterial stiffness (carotid-femoral pulse wave velocity), steady arterial load (systemic vascular resistance), and wave reflections (reflected pressure wave amplitude, augmentation index) compared with controls (
<0.05 for each). Fewer hemodynamic domains were altered in the preeclampsia with no CO group, with higher central diastolic blood pressure, systemic vascular resistance, and wave reflections than controls (
<0.05). Conclusions Women with previous preeclampsia who also experience CO have the greatest alterations in arterial health and hemodynamics. Patients with preeclampsia with CO may represent a higher-risk subgroup who could be targeted for risk stratification and primary prevention of cardiovascular disease. |
|---|---|
| AbstractList | Background Women with preeclampsia have a higher risk of cardiovascular disease. This is partly explained by the worse arterial health after preeclampsia. Central obesity (CO) is a risk factor for both preeclampsia and cardiovascular disease. Whether CO contributes to further worsening of arterial health after preeclampsia remains unclear. Our objective was to evaluate the effect of CO and previous preeclampsia on arterial hemodynamics. Methods and Results We studied 40 women with previous preeclampsia (<6 years) and 40 age-matched controls with previous normotensive pregnancy in the same timeframe. We estimated arterial hemodynamics with validated techniques combining applanation tonometry and echocardiography. CO was defined as a waist-to-hip ratio ≥0.85. Differences in arterial hemodynamics across the 3 groups (preeclampsia with CO, preeclampsia without CO, and controls) were assessed with multivariable linear regression models adjusted for potential confounders. Twenty-six (65%) of the participants with preeclampsia had CO compared with 18 (45%) controls. Mean waist-to-hip ratio in patients with preeclampsia with CO, those with preeclampsia and no CO, and controls was 0.94±0.05, 0.80±0.04, and 0.83±0.07, respectively. In multivariable analyses, women with preeclampsia and CO had higher central blood pressure, arterial stiffness (carotid-femoral pulse wave velocity), steady arterial load (systemic vascular resistance), and wave reflections (reflected pressure wave amplitude, augmentation index) compared with controls (
<0.05 for each). Fewer hemodynamic domains were altered in the preeclampsia with no CO group, with higher central diastolic blood pressure, systemic vascular resistance, and wave reflections than controls (
<0.05). Conclusions Women with previous preeclampsia who also experience CO have the greatest alterations in arterial health and hemodynamics. Patients with preeclampsia with CO may represent a higher-risk subgroup who could be targeted for risk stratification and primary prevention of cardiovascular disease. Background Women with preeclampsia have a higher risk of cardiovascular disease. This is partly explained by the worse arterial health after preeclampsia. Central obesity (CO) is a risk factor for both preeclampsia and cardiovascular disease. Whether CO contributes to further worsening of arterial health after preeclampsia remains unclear. Our objective was to evaluate the effect of CO and previous preeclampsia on arterial hemodynamics. Methods and Results We studied 40 women with previous preeclampsia (<6 years) and 40 age‐matched controls with previous normotensive pregnancy in the same timeframe. We estimated arterial hemodynamics with validated techniques combining applanation tonometry and echocardiography. CO was defined as a waist‐to‐hip ratio ≥0.85. Differences in arterial hemodynamics across the 3 groups (preeclampsia with CO, preeclampsia without CO, and controls) were assessed with multivariable linear regression models adjusted for potential confounders. Twenty‐six (65%) of the participants with preeclampsia had CO compared with 18 (45%) controls. Mean waist‐to‐hip ratio in patients with preeclampsia with CO, those with preeclampsia and no CO, and controls was 0.94±0.05, 0.80±0.04, and 0.83±0.07, respectively. In multivariable analyses, women with preeclampsia and CO had higher central blood pressure, arterial stiffness (carotid‐femoral pulse wave velocity), steady arterial load (systemic vascular resistance), and wave reflections (reflected pressure wave amplitude, augmentation index) compared with controls (P<0.05 for each). Fewer hemodynamic domains were altered in the preeclampsia with no CO group, with higher central diastolic blood pressure, systemic vascular resistance, and wave reflections than controls (P<0.05). Conclusions Women with previous preeclampsia who also experience CO have the greatest alterations in arterial health and hemodynamics. Patients with preeclampsia with CO may represent a higher‐risk subgroup who could be targeted for risk stratification and primary prevention of cardiovascular disease. Background Women with preeclampsia have a higher risk of cardiovascular disease. This is partly explained by the worse arterial health after preeclampsia. Central obesity (CO) is a risk factor for both preeclampsia and cardiovascular disease. Whether CO contributes to further worsening of arterial health after preeclampsia remains unclear. Our objective was to evaluate the effect of CO and previous preeclampsia on arterial hemodynamics. Methods and Results We studied 40 women with previous preeclampsia (<6 years) and 40 age-matched controls with previous normotensive pregnancy in the same timeframe. We estimated arterial hemodynamics with validated techniques combining applanation tonometry and echocardiography. CO was defined as a waist-to-hip ratio ≥0.85. Differences in arterial hemodynamics across the 3 groups (preeclampsia with CO, preeclampsia without CO, and controls) were assessed with multivariable linear regression models adjusted for potential confounders. Twenty-six (65%) of the participants with preeclampsia had CO compared with 18 (45%) controls. Mean waist-to-hip ratio in patients with preeclampsia with CO, those with preeclampsia and no CO, and controls was 0.94±0.05, 0.80±0.04, and 0.83±0.07, respectively. In multivariable analyses, women with preeclampsia and CO had higher central blood pressure, arterial stiffness (carotid-femoral pulse wave velocity), steady arterial load (systemic vascular resistance), and wave reflections (reflected pressure wave amplitude, augmentation index) compared with controls (P<0.05 for each). Fewer hemodynamic domains were altered in the preeclampsia with no CO group, with higher central diastolic blood pressure, systemic vascular resistance, and wave reflections than controls (P<0.05). Conclusions Women with previous preeclampsia who also experience CO have the greatest alterations in arterial health and hemodynamics. Patients with preeclampsia with CO may represent a higher-risk subgroup who could be targeted for risk stratification and primary prevention of cardiovascular disease.Background Women with preeclampsia have a higher risk of cardiovascular disease. This is partly explained by the worse arterial health after preeclampsia. Central obesity (CO) is a risk factor for both preeclampsia and cardiovascular disease. Whether CO contributes to further worsening of arterial health after preeclampsia remains unclear. Our objective was to evaluate the effect of CO and previous preeclampsia on arterial hemodynamics. Methods and Results We studied 40 women with previous preeclampsia (<6 years) and 40 age-matched controls with previous normotensive pregnancy in the same timeframe. We estimated arterial hemodynamics with validated techniques combining applanation tonometry and echocardiography. CO was defined as a waist-to-hip ratio ≥0.85. Differences in arterial hemodynamics across the 3 groups (preeclampsia with CO, preeclampsia without CO, and controls) were assessed with multivariable linear regression models adjusted for potential confounders. Twenty-six (65%) of the participants with preeclampsia had CO compared with 18 (45%) controls. Mean waist-to-hip ratio in patients with preeclampsia with CO, those with preeclampsia and no CO, and controls was 0.94±0.05, 0.80±0.04, and 0.83±0.07, respectively. In multivariable analyses, women with preeclampsia and CO had higher central blood pressure, arterial stiffness (carotid-femoral pulse wave velocity), steady arterial load (systemic vascular resistance), and wave reflections (reflected pressure wave amplitude, augmentation index) compared with controls (P<0.05 for each). Fewer hemodynamic domains were altered in the preeclampsia with no CO group, with higher central diastolic blood pressure, systemic vascular resistance, and wave reflections than controls (P<0.05). Conclusions Women with previous preeclampsia who also experience CO have the greatest alterations in arterial health and hemodynamics. Patients with preeclampsia with CO may represent a higher-risk subgroup who could be targeted for risk stratification and primary prevention of cardiovascular disease. |
| Author | Paquin, Amélie Werlang, Ana Coutinho, Thais |
| AuthorAffiliation | 4 Department of Cardiovascular Medicine Mayo Clinic Rochester MN 1 Division of Cardiology University of Ottawa Heart Institute Ottawa ON Canada 3 Department of Obstetrics and Gynecology The Ottawa Hospital Ottawa ON Canada 2 Canadian Women’s Heart Health Centre University of Ottawa Heart Institute Ottawa ON Canada |
| AuthorAffiliation_xml | – name: 1 Division of Cardiology University of Ottawa Heart Institute Ottawa ON Canada – name: 3 Department of Obstetrics and Gynecology The Ottawa Hospital Ottawa ON Canada – name: 2 Canadian Women’s Heart Health Centre University of Ottawa Heart Institute Ottawa ON Canada – name: 4 Department of Cardiovascular Medicine Mayo Clinic Rochester MN |
| Author_xml | – sequence: 1 givenname: Amélie orcidid: 0000-0003-2034-4196 surname: Paquin fullname: Paquin, Amélie organization: Division of Cardiology University of Ottawa Heart Institute Ottawa ON Canada, Canadian Women’s Heart Health Centre University of Ottawa Heart Institute Ottawa ON Canada – sequence: 2 givenname: Ana orcidid: 0000-0001-7979-1770 surname: Werlang fullname: Werlang, Ana organization: Department of Obstetrics and Gynecology The Ottawa Hospital Ottawa ON Canada – sequence: 3 givenname: Thais orcidid: 0000-0002-7735-5315 surname: Coutinho fullname: Coutinho, Thais organization: Division of Cardiology University of Ottawa Heart Institute Ottawa ON Canada, Canadian Women’s Heart Health Centre University of Ottawa Heart Institute Ottawa ON Canada, Department of Cardiovascular Medicine Mayo Clinic Rochester MN |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37929708$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1161/circulationaha.109.914507 10.1016/j.jacc.2022.03.335 10.1136/bmj.i1753 10.1002/oby.20099 10.1038/jhh.2013.81 10.1007/s11936-018-0653-8 10.1016/0735-1097(92)90198-v 10.1161/circresaha.118.313276 10.1161/hypertensionaha.116.07907 10.1161/cir.0000000000000973 10.1093/ajh/hpaa183 10.1016/s0140-6736(06)68967-8 10.1161/circresaha.120.316101 10.1111/nure.12055 10.1161/circresaha.116.307547 10.1098/rspb.1922.0022 10.2174/1573402113666170413094319 10.1016/s0140-6736(05)67726-4 10.1161/hypertensionaha.110.157339 10.1152/ajpheart.00202.2020 10.1097/aog.0000000000003891 10.1093/eurheartj/ehl254 10.1111/j.1471-0528.2006.01180.x 10.1016/j.jacc.2010.11.058 10.1161/hypertensionaha.114.03285 10.1152/ajpheart.1986.251.3.H588 10.1093/eurheartj/ehq165 10.1093/eurheartj/ehm026 10.1161/circulationaha.109.886655 10.1371/journal.pone.0059371 10.3390/antiox12061295 10.1161/jaha.115.002189 10.1161/hypertensionaha.120.14971 10.1161/hypertensionaha.120.16249 10.1161/jaha.122.028116 10.1161/hypertensionaha.121.18776 10.1172/jci112737 10.1038/ejcn.2009.139 10.1161/atvbaha.114.304798 10.1016/j.numecd.2015.01.002 10.1161/circulationaha.118.037630 10.1016/j.jacc.2013.09.063 10.1001/jamanetworkopen.2021.3808 10.1111/obr.13449 10.1093/eurheartj/ehq024 10.1053/j.ajkd.2018.04.018 |
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| Keywords | arterial stiffness central obesity arterial hemodynamics preeclampsia |
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| Snippet | Background Women with preeclampsia have a higher risk of cardiovascular disease. This is partly explained by the worse arterial health after preeclampsia.... |
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| SubjectTerms | Aging arterial hemodynamics arterial stiffness Blood Pressure Cardiovascular Diseases central obesity Female Hemodynamics Humans Hypertension Obesity Obesity, Abdominal Original Research Pre-Eclampsia preeclampsia Pregnancy Pulse Wave Analysis Vascular Stiffness |
| Title | The EVA (Early Vascular Aging) Study: Association of Central Obesity With Worse Arterial Health After Preeclampsia |
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