Reducing the risk of chronic hypertension and improving vascular function following preeclampsia

Project Abstract/Summary Hypertensive disorder of pregnancy (HDP) is a major public health problem especially postpartum. Postpartum hypertension (HTN) accounts for nearly 75% of maternal hemorrhagic strokes, heart failures, and deaths, one- third of which occurs in the first week after birth. Patients who survive these devastating complications face a

lifelong sequela of cardiovascular disease (CVD). The mechanisms behind the increased risk of CVD involve vascular dysfunction generated by HDP and further exacerbated by postpartum HTN. The postpartum period is a time of high vascular remodeling following pregnancy, and even more so following a hypertensive pregnancy.

Patients who had HDP have lower flow mediated dilation (FMD) and higher arterial stiffness measured by pulse wave velocity (PWV) compared to patients with no HDP. They also have higher levels of soluble fms-like tyrosine kinase-1 (sFlt-1), an anti-angiogenic protein that causes vasoconstriction and endothelial damage. Our

preliminary studies demonstrate that intensive blood pressure (BP) control to target of