Baroreceptor mediated blood pressure control in women with a history of preeclampsia

Objective. Preeclampsia (PE) is known to be associated with increased cardiovascular risk later in life. The mechanism linking preeclampsia and future cardiovascular risk is large­ly unknown. We hypothesize compromised autonomic reg­ulation of blood pressure. We therefore investigated barore­ceptor sensitivity (BRS) 5 to 10 years postpartum in women with a history of PE and compared the results with healthy controls.
Materials and Methods. Women were passively tilted from 0 to 60 degrees on a tilt table with continuous beat-to-beat blood pressure and heart rate measurements. The mean BRS was cal­culated based on a five-minute period following one minute of stabilization before and after head-up tilt.
Results. We included 66 formerly PE patients and 44 healthy controls. At 0 degrees, PE patients exhibit significantly high­er MAP (104.6 ± 11.6 mmHg) and lower BRS (9.2 ± 3.9 ms/ mmHg) compared to controls (88.5 ± 11.1 mmHg; 20.0 ± 7.3 ms/mmHg) (p < 0.05). With head-up tilt, blood pressure drop in PE patients is significantly more pronounced (-12.2 ± 8.5 mmHg) compared to controls (-4.4 ± 3.6 mmHg). The BRS modulation range was larger in controls compared with PE patients (mean: -12.6 ± 7.4 ms/mmHg vs -4.3 ± 4.0 ms/mmHg) independent of baseline MAP.
Conclusions. Women with a history of preeclampsia have reduced baroreceptor sensitivity and less range to modulate this sensitivity. Resultantly blood pressure drop with passive head-up tilt is more pronounced in formerly preeclamptic women, irrespective of initial blood pressure. This suggests compromised autonomic regulation of blood pressure in women with a history of preeclampsia.