Journal article
Load-Dependent Mechanisms Contribute to Increased Aortic Stiffness Among Women with a History of Preeclampsia: Relation with Cardiovagal Baroreflex Sensitivity
American journal of physiology. Heart and circulatory physiology, Vol.327(6), pp.H1406-H1412
12/01/2024
DOI: 10.1152/ajpheart.00556.2024
PMCID: PMC11684942
PMID: 39423036
Abstract
Introduction: Preeclampsia, a hypertensive disorder of pregnancy, results in increased lifetime cardiovascular disease (CVD) risk. Total aortic stiffness, a robust risk factor for CVD, is composed of load-dependent (blood pressure load on arterial wall) and structural (intrinsic changes in arterial wall) mechanisms. Total aortic stiffness is also associated with reduced cardiovagal baroreflex sensitivity (BRS). We sought to determine 1) whether elevated total aortic stiffness among women with a history of preeclampsia (hxPE) is attributed to load-dependent or structural stiffness, and 2) whether either mechanism is associated with lower BRS. Methods: Total aortic stiffness (carotid-femoral pulse wave velocity) and spontaneous cardiovagal BRS (sequence technique) were measured among women 1-5 years postpartum (n=115; age 34 ±4yrs; hxPE n=51; controls n=64). Structural aortic stiffness was calculated from participant-specific exponential models, standardizing aortic stiffness to a 'reference' blood pressure. Load-dependent stiffness was calculated as total minus structural stiffness. Results: Total (+0.8 m/sec, 95% CI (-0.99, -0.23), p=0.002) and load-dependent (+0.4 m/sec, 95% CI (-0.56, -0.22), P<0.001), but not structural (95% CI (-0.52, 0.08), p=0.16), aortic stiffness were higher among women with hxPE compared with controls. Women with a hxPE had lower BRS (p=0.042) that was negatively associated with total (B =-3.24 ms/mmHg, 95% CI (-6.35, -0.13), p=0.042) and load-dependent (B =-5.91ms/mmHg, 95% CI (-11.31, -0.51), p=0.033) aortic stiffness. Conclusion: Load-dependent, not structural, aortic stiffness mechanisms contribute to higher total aortic stiffness among women with hxPE and was associated with lower cardiovagal BRS. Postpartum BP monitoring is critical to reduce increased CVD risk in preeclampsia.Introduction: Preeclampsia, a hypertensive disorder of pregnancy, results in increased lifetime cardiovascular disease (CVD) risk. Total aortic stiffness, a robust risk factor for CVD, is composed of load-dependent (blood pressure load on arterial wall) and structural (intrinsic changes in arterial wall) mechanisms. Total aortic stiffness is also associated with reduced cardiovagal baroreflex sensitivity (BRS). We sought to determine 1) whether elevated total aortic stiffness among women with a history of preeclampsia (hxPE) is attributed to load-dependent or structural stiffness, and 2) whether either mechanism is associated with lower BRS. Methods: Total aortic stiffness (carotid-femoral pulse wave velocity) and spontaneous cardiovagal BRS (sequence technique) were measured among women 1-5 years postpartum (n=115; age 34 ±4yrs; hxPE n=51; controls n=64). Structural aortic stiffness was calculated from participant-specific exponential models, standardizing aortic stiffness to a 'reference' blood pressure. Load-dependent stiffness was calculated as total minus structural stiffness. Results: Total (+0.8 m/sec, 95% CI (-0.99, -0.23), p=0.002) and load-dependent (+0.4 m/sec, 95% CI (-0.56, -0.22), P<0.001), but not structural (95% CI (-0.52, 0.08), p=0.16), aortic stiffness were higher among women with hxPE compared with controls. Women with a hxPE had lower BRS (p=0.042) that was negatively associated with total (B =-3.24 ms/mmHg, 95% CI (-6.35, -0.13), p=0.042) and load-dependent (B =-5.91ms/mmHg, 95% CI (-11.31, -0.51), p=0.033) aortic stiffness. Conclusion: Load-dependent, not structural, aortic stiffness mechanisms contribute to higher total aortic stiffness among women with hxPE and was associated with lower cardiovagal BRS. Postpartum BP monitoring is critical to reduce increased CVD risk in preeclampsia.
Details
- Title: Subtitle
- Load-Dependent Mechanisms Contribute to Increased Aortic Stiffness Among Women with a History of Preeclampsia: Relation with Cardiovagal Baroreflex Sensitivity
- Creators
- Kristen G Davis - University of IowaMatthew K Armstrong - University of IowaVirginia R Nuckols - University of IowaMeaghan N Smith - University of IowaRyan Pewowaruk - LEK Consulting (United States)Colin J Gimblet - University of IowaDonna A Santillan - University of IowaMark K Santillan - University of IowaGary L Pierce - University of Iowa
- Resource Type
- Journal article
- Publication Details
- American journal of physiology. Heart and circulatory physiology, Vol.327(6), pp.H1406-H1412
- DOI
- 10.1152/ajpheart.00556.2024
- PMID
- 39423036
- PMCID
- PMC11684942
- NLM abbreviation
- Am J Physiol Heart Circ Physiol
- ISSN
- 1522-1539
- eISSN
- 1522-1539
- Publisher
- AMER PHYSIOLOGICAL SOC
- Grant note
- American Heart Association: 18SCG34350001, 969732 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
This study was funded by American Heart Association Grants 18SCG34350001 (to M.K.S.) and 969732 (to G.LP). 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. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
- Language
- English
- Electronic publication date
- 10/18/2024
- Date published
- 12/01/2024
- Academic Unit
- Obstetrics and Gynecology; Health, Sport, and Human Physiology ; Internal Medicine
- Record Identifier
- 9984736749202771
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