Comparison of arterial stiffness in preeclamptic and normotensive pregnant women from a semi-rural region of South Africa

Background: Preeclampsia is associated with arterial stiffness and endothelial dysfunction. The pathophysiology of arterial tone in preeclampsia has not been well described in rural African population, where the incidence is higher. Objective: The aim of the study was to compare arterial tone of preeclamptic with pregnant normotensive women assessed with noninvasive techniques, using applanation tonometry with SphygmoCor. Method: This was a cross-sectional study. Participants were recruited from Mthatha General Hospital complex Antenatal clinics during their third trimester. A hundred and twelve (112) normotensive and 85 preeclamptic women (PE) were recruited into the study. Arterial stiffness was assessed using applanation tonometry with SphygmoCor device; central aortic pressures, peripheral and central augmentation index (Alx), and carotid–femoral pulse wave velocity (PWV) were then calculated. Data were analyzed using STATISTICA version 10 software. Results: Pulse wave velocity was significantly higher in preeclamptic than normotensive women (6.6 IQR 1.8 versus 5.0 IQR 1.2; p = 0.000).Central augmentation index corrected to heart rate of 75 was significant higher in preeclamptic than normotensives women (23.4 ± 12.4 versus 12.8 ± 12) with p < 0.002. Early-onset preeclampsia had significantly higher brachial diastolic blood pressure (87 IQR 79-101.5 versus 82 IQR 65-88; p = 0.0198) than late-onset preeclampsia. Conclusion: This study has demonstrated that women of rural Eastern Cape with preeclampsia have increased pulse wave velocity and peripheral augmentation index. This shows that preeclamptic women from rural Eastern Cape of South Africa have increased arterial stiffness

Arterial stiffness in women previously with preeclampsia from a semi-rural region of South Africa

Women with pre-eclampsia have an increased risk of cardiovascular disease later in life. The aim of the study was to establish the presence and pattern of arterial stiffness in women previously with pre-eclampsia from a semi-rural region of South Africa. This was a prospective longitudinal study which involved 36 previously pre-eclamptic women and 86 non-pregnant controls (NPC) who had a past history of non-complicated pregnancy. Maternal wave reflection (augmentation index) and carotid-femoral pulse wave velocity were assessed noninvasively, using applanation tonometry with the SphygmoCor device. Endothelial function was assessed by EndoPAT 2000 device; pneumatic probes were fitted to the index fingers; induced flow-mediated reactive hyperemia; the ratio of the readings before and after occlusion was then used to calculate the score, the reactive hyperemia index (RHI) as a measure of endothelial function. Pulse wave velocity remained significantly higher in previously pre-eclamptic women than non-pregnant controls up to three months after delivery (p < 0.05), then it reduced to nonsignificant values. All blood pressure indices (central and brachial pressures), were higher in previously pre-eclamptic women as compared to nonpregnant controls up to one year postpartum. Regional (aortic) arterial stiffness, though it persists for some time after delivery, is transitory in previously pre-eclamptic women from the rural Africa setting. However, their increase blood pressure is an indication of compromised arterial compliance in women previously with pre-eclampsia