Abstract
Objective
To measure carotid artery intima-media thickness (CIMT), a marker of subclinical atherosclerosis,
in postmenopausal women with and without histories of preeclampsia and to synthesize
these results with those from prior studies of CIMT performed 10 or more years after
preeclamptic pregnancies.
Patients and Methods
Forty women (median age, 59 years) with histories of preeclampsia and 40 with histories
of normotensive pregnancy (confirmed by medical record review) were selected from
women who resided and gave birth in Olmsted County, Minnesota, between January 1,
1976, and December 31, 1982. The participants were identified and recruited in 2014-2015,
and CIMT was measured by B-mode ultrasonography. Meta-analysis included CIMT studies
that were performed 10 or more years after preeclamptic pregnancies and which were
identified through PubMed, EMBASE, and Web of Science. Heterogeneity was assessed
using the I2 statistic. Standardized mean difference was used as a measure of effect size.
Results
Carotid artery intima-media thickness, expressed as a median (interquartile range),
was greater in the preeclamptic than in the normotensive group (0.80 mm [0.75-0.85
mm] vs 0.73 mm [0.70-0.78]; P=.004); the odds of having CIMT higher than threshold (0.77 mm) was statistically
significant after adjusting for confounding factors (odds ratio, 3.17; 95% CI, 1.10-9.14).
A meta-analysis of 10 studies conducted 10 or more years post partum included 813
women with and 2874 without histories of preeclampsia. Carotid artery intima-media
thickness was greater among women with histories of preeclampsia, with a standardized
mean difference of 0.18 and 95% CI of 0.05 to 0.30 mm (P=.004).
Conclusion
Among women with histories of preeclampsia, CIMT may identify those with subclinical
atherosclerosis, thus offering an opportunity for early intervention.
Abbreviations and Acronyms:
BMI (body mass index), CAC (coronary artery calcification), CIMT (carotid artery intima-media thickness), CVD (cardiovascular disease), DBP (diastolic blood pressure), HOMA-IR (homeostatic model assessment for insulin resistance), IQR (interquartile range), OR (odds ratio), PO (proportional odds), SBP (systolic blood pressure), REP (Rochester Epidemiology Project), SMD (standardized mean difference)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: August 25, 2017
Footnotes
For editorial comment, see page 1323
Grant Support: This study was supported by grant P50 AG044170 from the National Institutes of Health , the Rochester Epidemiology Project (grant number R01-AG034676; Principal Investigators: Walter A. Rocca, MD, MPH, and Jennifer L. St. Sauver, PhD), grant UL1 TR000135 from the National Center for Advancing Translational Sciences , a Mayo Clinic Clinical and Translational Science Award, the Mayo Clinic Department of Surgery, and the Mayo Foundation.
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© 2017 Mayo Foundation for Medical Education and Research
