Vesna D Garovic1, Natasa M Milic2, Tracey L Weissgerber3, Michelle M Mielke4, Kent R Bailey5, Brian Lahr5, Muthuvel Jayachandran6, Wendy M White7, Howard N Hodis8, Virginia M Miller9. 1. Department of Internal Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN. Electronic address: garovic.vesna@mayo.edu. 2. Department of Internal Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN; Department of Biostatistics, Medical Faculty, University of Belgrade, Belgrade, Serbia. 3. Department of Internal Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN. 4. Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, MN; Department of Neurology, Mayo Clinic, Rochester, MN. 5. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN. 6. Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN. 7. Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN. 8. Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA. 9. Department of Surgery, Mayo Clinic, Rochester, MN.
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.
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.
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