Title:Arterial Stiffness as a Cardiovascular Risk Factor for the Development of Preeclampsia and Pharmacopreventive Options
Volume: 20
Issue: 1
Author(s): Christos Anthoulakis*, Apostolos Mamopoulos, David Rousso, Asterios Karagiannis, Apostolos Athanasiadis, Grigoris Grimbizis and Vasilios Athyros
Affiliation:
- First Department of Obstetrics & Gynecology, “Papageorgiou” General Hospital, Aristotle University of Thessaloniki,
Thessaloniki, Greece
Keywords:
Aspirin, blood pressure, cardiovascular diseases, hypertension, preeclampsia, pregnancy complications, pulse wave analysis, vascular stiffness.
Abstract: Arterial Stiffness (AS) describes the rigidity of the arterial walls. Epidemiological
studies have shown that increased AS is an independent predictive marker of Cardiovascular (CV)
morbidity and mortality in both pregnant and non-pregnant women. Preeclampsia (PE), a form of
pregnancy-induced hypertension, affects approximately 5% of pregnancies worldwide. Preeclamptic
women have a higher risk of CV Disease (CVD), mainly because PE damages the heart’s ability
to relax between contractions. Different pharmacological approaches for the prevention of PE have
been tested in clinical trials (e.g., aspirin, enoxaparin, metformin, pravastatin, and sildenafil citrate).
In current clinical practice, only low-dose aspirin is used for PE pharmacoprevention. However,
low-dose aspirin does not prevent term PE, which is the most common form of PE. Compromised
vascular integrity precedes the onset of PE and therefore, AS assessment may constitute a
promising predictive marker of PE. Several non-invasive techniques have been developed to assess
AS. Compared with normotensive pregnancies, both Carotid-Femoral Pulse Wave Velocity (cfPWV)
and Augmentation Index (AIx) are increased in PE. In view of simplicity, reliability, and reproducibility,
there is an interest in oscillometric AS measurements in pregnancies complicated by
PE.
