Pulse Pressure Amplification and Arterial Stiffness in Low-Risk, Uncomplicated Pregnancies

Abstract

Background: Arterial stiffness, a composite indicator of vascular health and predictor of future cardiovascular (CV) disease and events, was assessed in low-risk, uncomplicated pregnancies. Methods: Women with low-risk pregnancy were recruited consecutively (recruitment across the 3 trimesters). Vessel hemodynamics and arterial stiffness were measured every 4 weeks from recruitment until delivery and at 6.5 weeks postpartum. Results: Sixty-three women (maternal age: 32.7 ± 4.9 years) with low-risk, uncomplicated pregnancy were recruited. Mean arterial pressure ( P = .04) and aortic pulse pressure ( P = .03) decreased during pregnancy, whereas heart rate gradually increased until delivery ( P = .0002) and decreased postpartum ( P = .06). Pulse pressure amplification (PPA) and carotid-to-radial pulse wave velocity initially decreased in the second trimester, followed by a steady increase until delivery ( P = .01 and P = .04, respectively). Interestingly, PPA sharply decreased postpartum ( P = .01). Augmentation index and the subendocardial viability ratio significantly increased postpartum ( P = .03 and .02, respectively). Conclusion: The PPA increased steadily after the second trimester and was sharply decreased postpartum in low-risk, uncomplicated pregnancy. Longer and larger longitudinal studies will evaluate changes in PPA and its potential as a marker of CV risk later in women’s life.