Objective: The mechanisms underlying increased cardio vascular risk among women with a history of pre-eclampsia remain unclear. Imp aired endothelial function has been observed in both pre-eclampsia and atherosc lerosis, and provides a plausible link between the two conditions. We studied en dothelial function and arterial compliance in non-pregnant, previously pre-ecl amptic women. Design: A study of 30 women with a history of pre-eclampsia and 2 1 women with a previous normotensive, uncomplicated pregnancy was carried out. M ethods: Changes in brachial artery blood flow, induced by intra-arterial infusi ons of an endothelium-independent(sodium nitroprusside) and an endothelium-dep endent(acetylcholine) vasodilator,were measured by venous occlusion plethysmogra phy. Arterial stiffness was assessed by pulse wave analysis. Results: Vasodilata tion was impaired in women with previous pre-eclampsia; at low and high concent rations of endothelium-independent(P=0.004 and P=0.057, respectively) and endot helium-dependent(P=0.045 and P=0.02) vasodilators, respectively. There was no d ifference in arterial stiffness between the groups(P=0.45). In multipleregressi on analyses both endothelium-independent and endothelium-dependent vasodilatat ions were independently associated with a history of pre-eclampsia and parity. There was no correlation with blood pressure, body mass index(BMI), smoking or a ge. Conclusions: The finding of impaired vascular dilatation several years after a pre-eclam-ptic pregnancy could contribute to the higher risk of cardiovascu lar disease in these women.
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