No accelerated arterial aging in relatively young women after preeclampsia as compared to normotensive pregnancy

IntroductionPreeclampsia, an endothelial disorder of pregnancy, predisposes to remote cardiovascular diseases (CVD). Whether there is an accelerated effect of aging on endothelial decline in former preeclamptic women is unknown. We investigated if the arterial aging regarding endothelial-dependent and -independent vascular function is more pronounced in women with a history of preeclampsia as compared to women with a history of solely normotensive gestation(s).MethodsData was used from the Queen of Hearts study (ClinicalTrials.gov Identifier NCT02347540); a large cross-sectional study on early detection of cardiovascular disease among young women (≥18 years) with a history of preeclampsia and a control group of low-risk healthy women with a history of uncomplicated pregnancies. Brachial artery flow-mediated dilation (FMD; absolute, relative and allometric) and sublingually administered nitroglycerine-mediated dilation (NGMD; absolute and relative) were measured using ultrasound. Cross-sectional associations of age with FMD and NGMD were investigated by linear regression. Models were adjusted for body mass index, smoking, antihypertensive drug use, mean arterial pressure, fasting glucose, menopausal state, family history of CVD and stress stimulus during measurement. Effect modification by preeclampsia was investigated by including an interaction term between preeclampsia and age in regression models.ResultsOf the 1,217 included women (age range 22–62 years), 66.0% had a history of preeclampsia and 34.0% of normotensive pregnancy. Advancing age was associated with a decrease in relative FMD and NGMD (unadjusted regression coefficient: FMD: −0.48%/10 years (95% CI:−0.65 to −0.30%/10 years), NGMD: −1.13%/10 years (−1.49 to −0.77%/10 years)) and increase in brachial artery diameter [regression coefficient = 0.16 mm/10 years (95% CI 0.13 to 0.19 mm/10 years)]. Similar results were found when evaluating FMD and NGMD as absolute increase or allometrically, and after confounder adjustments. These age-related change were comparable in former preeclamptic women and controls (p-values interaction ≥0.372). Preeclampsia itself was independently associated with consistently smaller brachial artery diameter, but not with FMD and NGMD.ConclusionIn young- to middle-aged women, vascular aging in terms of FMD and NGMD was not accelerated in women after preeclampsia compared to normotensive pregnancies, even though former preeclamptic women consistently have smaller brachial arteries

On-line solid phase extraction-gas chromatography-cryotrapping-infrared spectrometry for the trace-level determination of microcontaminants in aqueous samples.

A large-volume on-column GC-cryotrapping-IR system was developed for injections of up to 100 μl of organic extracts. Considerable reduction of the solvent-and-water background and enhanced analyte detectability was achieved by using an open-split interface between the GC column and the IR detector and improving the leak-tightness of the system. The system was combined with solid-phase extraction to yield on-line SPE-GC-IR. With this set-up, sample volumes of only 20 ml sufficed to detect, and identify, microcontaminants in tap and surface water at the 0.1-1 μg/L level. Detection limits were on the order of 15 ng/L for tap water when using appropriate functional-group chromatograms. Or, in other words, SPE-GC-IR is a suitable technique for the screening of environmental water samples for functional groups, i.e. classes of compounds, of interest

Maternal metabolic syndrome, preeclampsia, and small for gestational age infancy

OBJECTIVE: We sought to explore to what extent the presence of cardiometabolic and cardiovascular risk constitutions differ between pregnancies complicated by small-for-gestational-age (SGA) infancy, preeclampsia (PE), or a combination of both. STUDY DESIGN: We conducted a cohort study in women after pregnancies complicated by placental syndrome with fetal manifestations (SGA infancy [n - 113]), maternal manifestations (PE [n = 729]), or both (n = 461). Independent sample t test was used to compare cardiometabolic and cardiovascular risk factors between groups. Logistic regression was used to calculate odds ratios and adjusted odds ratios of the prevalence of the metabolic syndrome and its constituents between groups. Adjustments were made for maternal age, parity, smoking, interval between delivery and measurements, and intrauterine fetal demise. RESULTS: The metabolic syndrome was present in 7.5% of women who delivered SGA infants, 15.6% of former PE women, and 19.8% of women after pregnancy complicated by both SGA and PE. Hypertension was observed in 25% of former PE women and 15% of women with solely SGA. Women who delivered a SGA infant had lower global vascular compliance compared to former PE women without SGA. CONCLUSION: Cardiometabolic risk factors consistent with metabolic syndrome relate to the maternal rather than to the fetal presentation of placental syndrome. Nonetheless, highest incidence of metabolic syndrome was observed in women with both PE and SGA. PE relates to chronic hypertension, whereas increased arterial stiffness seems to be associated with women who deliver a SGA infant

Sustaining collective action in urban community gardens

This paper presents an agent-based model that explores the conditions for ongoing participation in community gardening projects. We test the effects of Ostrom’s well-known Design Principles for collective action and use an extensive database collected in 123 cases in Germany and two case studies in the Netherlands to validate it. The model uses the Institutional Analysis and Development (IAD) framework and integrates decision mechanisms derived from the Theory of Reasoned Action (TRA). This allows the analysis of volunteer participation in urban community gardens over time, based on the garden’s institutions (Design Principles) and the volunteer’s intention to join gardening. This intention is influenced by the volunteer’s expectations and past experiences in the garden (TRA). We find that not all Design Principles lead to higher levels of participation but rather, participation depends on specific combinations of the Design Principles. We highlight the need to update the assumption about sanctioning in such systems: sanctioning is not always beneficial, and may be counter-productive in certain contexts.Energy & IndustryOLD SnC CultureApplied Science

Prediction model for hypertension in first decade after pre-eclampsia in initially normotensive women

OBJECTIVE: To develop a prediction model for the development of hypertension in the decade following pre-eclampsia in women who were initially normotensive shortly after pregnancy. METHODS: We conducted a longitudinal cohort study in 259 formerly pre-eclamptic women in a University hospital in The Netherlands. We developed a prediction model using multivariable logistic regression analysis. The model was internally validated with bootstrapping techniques. RESULTS: Of the 259 women, 185 (71%) were normotensive at first visit at a median of 10 months [interquartile range, 6-24] postpartum of which 49 (26%) had developed hypertension at the second visit at a median of 11?years postpartum. The prediction model, based on birth-weight centile, mean arterial pressure, total cholesterol, left ventricular mass index and left ventricular ejection fraction, had a good to excellent discriminative ability of AUC-ROC-curve 0.82 (95% CI, 0.75-0.89) with an optimism corrected AUC of 0.80. Sensitivity and specificity of our model to predict hypertension was 98% and 65%, respectively, and positive and negative predictive values were 50% and 99%, respectively. CONCLUSIONS: Based on five variables, we developed a good-to-excellent performing predictive tool to identify incident hypertension following pre-eclampsia in women that were normotensive shortly after pregnancy. After external validation, this model could have considerable clinical utility in tackling the cardiovascular legacy of pre-eclampsia. This article is protected by copyright. All rights reserved