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Long-term microvascular and blood pressure dysregulation after Preeclampsia

Jälmby, Maya LU ; Edvinsson, Camilla LU ; Lykou, Despoina LU orcid ; Karampas, Grigorios LU ; Erlandsson, Lena LU ; Hansson, Stefan R. LU orcid and Piani, Federica LU (2025) In Hypertension Research 48(6). p.1972-1982
Abstract

Preeclampsia (PE) is a pregnancy disorder characterized by systemic endothelial damage that leads to long-term cardiovascular complications. The endothelial glycocalyx (EG) covers the luminal surface of endothelium playing a critical role in vascular homeostasis. In this study we aimed to evaluate EG thickness and blood pressure (BP) trends in women with a history of PE vs. normotensive pregnancy. Fifty-five women participated in the study (18 controls, 34 with PE, and 3 with gestational hypertension). Six years postpartum, we evaluated the sublingual microcirculation by sidestream dark-field microscopy, and assessed BP in the sitting and orthostatic position. At follow-up, women with PE had reduced EG thickness in vessels ≥ 8 µm,... (More)

Preeclampsia (PE) is a pregnancy disorder characterized by systemic endothelial damage that leads to long-term cardiovascular complications. The endothelial glycocalyx (EG) covers the luminal surface of endothelium playing a critical role in vascular homeostasis. In this study we aimed to evaluate EG thickness and blood pressure (BP) trends in women with a history of PE vs. normotensive pregnancy. Fifty-five women participated in the study (18 controls, 34 with PE, and 3 with gestational hypertension). Six years postpartum, we evaluated the sublingual microcirculation by sidestream dark-field microscopy, and assessed BP in the sitting and orthostatic position. At follow-up, women with PE had reduced EG thickness in vessels ≥ 8 µm, expressed by an increased perfused boundary region (PBR), compared to healthy controls (median 3.14 vs. 2.88 µm, p = 0.002). A trend towards increased red blood cell velocity in vessels ≥ 10 µm was also observed in PE vs. controls. The systolic and diastolic BP, as well as within-visit BP variability, were significantly higher in PE vs. controls. Adverse neonatal outcomes, umbilical artery Doppler and BP during both the pregnancy and the follow-up visit, were associated with maternal PBR value in vessels ≥ 8 µm. This study contributes to the existing literature on PE and the increased risk of future cardiovascular disease, highlighting the critical role of EG and BP regulatory mechanisms. Our results showed that the severity of hemodynamic and neonatal impairments during pregnancy may irreversibly affect the EG and thereby be associated with long-term maternal vascular dysfunction. (Figure presented.)

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Endothelial dysfunction, Glycocalyx, Hypertension, Hypertensive disorders of pregnancy, Preeclampsia
in
Hypertension Research
volume
48
issue
6
pages
11 pages
publisher
Nature Publishing Group
external identifiers
  • pmid:40175678
  • scopus:105001678305
ISSN
0916-9636
DOI
10.1038/s41440-025-02176-1
language
English
LU publication?
yes
id
8a17c178-9eed-492c-a061-6706192055d8
date added to LUP
2025-09-04 10:11:30
date last changed
2025-09-18 11:02:58
@article{8a17c178-9eed-492c-a061-6706192055d8,
  abstract     = {{<p>Preeclampsia (PE) is a pregnancy disorder characterized by systemic endothelial damage that leads to long-term cardiovascular complications. The endothelial glycocalyx (EG) covers the luminal surface of endothelium playing a critical role in vascular homeostasis. In this study we aimed to evaluate EG thickness and blood pressure (BP) trends in women with a history of PE vs. normotensive pregnancy. Fifty-five women participated in the study (18 controls, 34 with PE, and 3 with gestational hypertension). Six years postpartum, we evaluated the sublingual microcirculation by sidestream dark-field microscopy, and assessed BP in the sitting and orthostatic position. At follow-up, women with PE had reduced EG thickness in vessels ≥ 8 µm, expressed by an increased perfused boundary region (PBR), compared to healthy controls (median 3.14 vs. 2.88 µm, p = 0.002). A trend towards increased red blood cell velocity in vessels ≥ 10 µm was also observed in PE vs. controls. The systolic and diastolic BP, as well as within-visit BP variability, were significantly higher in PE vs. controls. Adverse neonatal outcomes, umbilical artery Doppler and BP during both the pregnancy and the follow-up visit, were associated with maternal PBR value in vessels ≥ 8 µm. This study contributes to the existing literature on PE and the increased risk of future cardiovascular disease, highlighting the critical role of EG and BP regulatory mechanisms. Our results showed that the severity of hemodynamic and neonatal impairments during pregnancy may irreversibly affect the EG and thereby be associated with long-term maternal vascular dysfunction. (Figure presented.)</p>}},
  author       = {{Jälmby, Maya and Edvinsson, Camilla and Lykou, Despoina and Karampas, Grigorios and Erlandsson, Lena and Hansson, Stefan R. and Piani, Federica}},
  issn         = {{0916-9636}},
  keywords     = {{Endothelial dysfunction; Glycocalyx; Hypertension; Hypertensive disorders of pregnancy; Preeclampsia}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1972--1982}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Hypertension Research}},
  title        = {{Long-term microvascular and blood pressure dysregulation after Preeclampsia}},
  url          = {{http://dx.doi.org/10.1038/s41440-025-02176-1}},
  doi          = {{10.1038/s41440-025-02176-1}},
  volume       = {{48}},
  year         = {{2025}},
}