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Postpartum Low-Dose Aspirin Does Not Improve Vascular Endothelial Function in Women with a History of Preeclampsia
Abstract   Peer reviewed

Postpartum Low-Dose Aspirin Does Not Improve Vascular Endothelial Function in Women with a History of Preeclampsia

Ruda Lee, Mark Santillan, Gary Pierce and Anna Stanhewicz
Physiology (Bethesda, Md.), Vol.41(S1), 2297754
05/2026
DOI: 10.1152/physiol.2026.41.S1.2297754

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Abstract

Abstract only Women with a history of preeclampsia (hxPE) are at an elevated risk for future cardiovascular disease. This increased risk is mediated in part by persistent endothelial dysfunction that may be reversible through pharmacological and/or lifestyle intervention. Low-dose aspirin (LDA) is commonly prescribed in high-risk pregnancies to reduce the incidence and severity of preeclampsia, and its beneficial effects are attributed to antiplatelet, anti-inflammatory, and endothelial actions. However, whether LDA initiated after pregnancy may improve endothelial function in women with a hxPE remains unclear. We hypothesized that 12 weeks of LDA would improve endothelial function in women with a hxPE. In a double-blind, randomized, parallel design, women with a hxPE were assigned to receive LDA (162 mg/day; n=10; 36±6 years; 27±17 months postpartum) or placebo (n=11; 31±5 years; 27±16 months postpartum) for 12 weeks. Macro- and microvascular assessments were performed at baseline and after 12 weeks of treatment. Macrovascular endothelial function was assessed using brachial artery flow-mediated dilation (FMD). Microvascular endothelial function was assessed as cutaneous vascular conductance (%max) during graded infusions of acetylcholine (Ach; 10-10-10-1M) alone or with 15 mM NG-nitro-L-arginine methyl ester (L-NAME; NO-synthase inhibitor). There were no differences in endothelial function between placebo and aspirin groups at baseline. Blood pressure and blood chemistry did not change in either group across the intervention (P>0.11). FMD did not change in the aspirin (pre: 5.8±2.1% vs. post: 5.9±2.1%; P=0.46) or placebo treated group (pre: 5.9±1.4% vs. post: 6.1±1.4%; P=0.31). Similarly, Ach-mediated microvascular vasodilation was not different between pre- and post-intervention in either group (P>0.08). In contrast, vasodilation responses to Ach+L-NAME decreased after 12 weeks in the aspirin group (P< 0.01) but not in the placebo-treated group. Therefore, 12 weeks of LDA treatment did not improve macrovascular or microvascular endothelial function in women with a hxPE, suggesting that LDA alone may not be a viable approach to reverse persistent endothelial dysfunction after pregnancy in these women. Funding: American Heart Association CDA 937990 This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.
 Environmental & Exercise Physiology

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