Higher carotid artery backward pressure and load-dependent stiffness among women with a history of preeclampsia: association with cognitive functions

Kristen G. Davis; Matthew K. Armstrong; Virginia R. Nuckols; Ryan Pewowaruk; Donna A. Santillan; Mark K. Santillan; Gary L. Pierce

doi:10.1152/japplphysiol.00755.2025

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Higher carotid artery backward pressure and load-dependent stiffness among women with a history of preeclampsia: association with cognitive functions

Kristen G. Davis, Matthew K. Armstrong, Virginia R. Nuckols, Ryan Pewowaruk, Donna A. Santillan, Mark K. Santillan and Gary L. Pierce

Journal of applied physiology (1985), Vol.140(3), pp.754-763

03/2026

DOI: 10.1152/japplphysiol.00755.2025

PMID: 41685981

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Abstract

Introduction: Women with a history of preeclampsia (hxPE) show reduced executive function (EF) and processing speed (PS) compared with a healthy pregnancy (HP). Central (carotid) artery pulsatile pressure hemodynamics and stiffness are associated with reduced cognitive function with aging; but it is unknown if this relation exists in women with a hxPE. We hypothesized that higher carotid artery pulsatile pressure hemodynamics and stiffness would mediate reductions in cognitive function among women with a hxPE. Methods: Carotid artery applanation tonometry, B-mode ultrasonography, and wave separation analysis were used in 121 postpartum women (9 months-5 years after delivery, aged 18-45; n=59 hxPE and n=62 HP) to calculate forward (Pf) and backward (Pb) pressure wave amplitudes, and pulse pressure (PP). Carotid stiffness components were derived by participant-specific exponential modeling. EF and PS were represented as Z-scores. Mediation analysis determined the contribution of carotid outcomes in the association between preeclampsia status and cognitive function. Results: Women with a hxPE had higher carotid Pb, PP, and load-dependent stiffness compared with HP (body mass index and age adjusted, p=0.009, p=0.005, and p<0.001, respectively). After education and age adjustment, the hxPE group had significantly lower PS compared with HP (p=0.009); executive function was not different (p=0.08). No pulsatile pressure hemodynamic or stiffness factor mediated associations between preeclampsia status and PS (all p>0.05). Conclusion: Women with a hxPE have greater carotid PP, Pb and load-dependent stiffness, compared with a HP. Neither carotid artery pulsatile pressure hemodynamics or load-dependent stiffness mediated lower PS among women with a hxPE.

Hemodynamics

arterial stiffness

carotid

cognitive performance

preeclampsia

Details

Title: Subtitle: Higher carotid artery backward pressure and load-dependent stiffness among women with a history of preeclampsia: association with cognitive functions
Creators: Kristen G. Davis - University of Iowa
Matthew K. Armstrong - University of Iowa
Virginia R. Nuckols - University of Iowa
Ryan Pewowaruk
Donna A. Santillan - University of Iowa
Mark K. Santillan - University of Iowa
Gary L. Pierce - University of Iowa
Resource Type: Journal article
Publication Details: Journal of applied physiology (1985), Vol.140(3), pp.754-763
DOI: 10.1152/japplphysiol.00755.2025
PMID: 41685981
NLM abbreviation: J Appl Physiol
ISSN: 8750-7587
eISSN: 1522-1601
Publisher: American Physiological Society
Grant note: American Heart Association: 969732, 18SCG34350001 Russell B. Day and Florence D. Day Endowed Chair in Liberal Arts and Sciences at the University of IowaNational Center for Advancing Translational Sciences of the National Institutes of Health: UM1TR004403 HAWK-IDDRC: IH/NICHD P50 HD103556 College of Liberal Arts and Sciences at the University of IowaAmerican Heart Association (AHA): 969732
This work is funded by American Heart Association Grants 969732 (to G.L.P.) and 18SCG34350001 (to M.K.S.). G.L.P. is supported by the Russell B. Day and Florence D. Day Endowed Chair in Liberal Arts and Sciences at the University of Iowa. Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UM1TR004403. M.K.S. is also supported by HD08994005 and HAWK-IDDRC Grant IH/NICHD P50 HD103556. K.G.D. was partially supported by a Dissertation Writing Fellowship from the College of Liberal Arts and Sciences at the University of Iowa.
Language: English
Electronic publication date: 02/13/2026
Date published: 03/2026
Academic Unit: Obstetrics and Gynecology; Health, Sport, and Human Physiology ; Internal Medicine
Record Identifier: 9985139315302771

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