Comparison of arterial stiffness in preeclamptic and normotensive pregnant women from a semi-rural region of South Africa

Abstract

ABSTRACTBackground: Preeclampsia is associated with arterial stiffness and endothelial dysfunction. The pathophysiology of arterial tone in preeclampsia has not been well described in rural African population, where the incidence is higher. Objective: The aim of the study was to compare arterial tone of preeclamptic with pregnant normotensive women assessed with noninvasive techniques, using applanation tonometry with SphygmoCor. Method: This was a cross-sectional study. Participants were recruited from Mthatha General Hospital complex Antenatal clinics during their third trimester. A hundred and twelve (112) normotensive and 85 preeclamptic women (PE) were recruited into the study. Arterial stiffness was assessed using applanation tonometry with SphygmoCor device; central aortic pressures, peripheral and central augmentation index (Alx), and carotid–femoral pulse wave velocity (PWV) were then calculated. Data were analyzed using STATISTICA version 10 software. Results: Pulse wave velocity was significantly higher in preeclamptic than normotensive women (6.6 IQR 1.8 versus 5.0 IQR 1.2; p = 0.000).Central augmentation index corrected to heart rate of 75 was significant higher in preeclamptic than normotensives women (23.4 ± 12.4 versus 12.8 ± 12) with p < 0.002. Early-onset preeclampsia had significantly higher brachial diastolic blood pressure (87 IQR 79-101.5 versus 82 IQR 65-88; p = 0.0198) than late-onset preeclampsia. Conclusion: This study has demonstrated that women of rural Eastern Cape with preeclampsia have increased pulse wave velocity and peripheral augmentation index. This shows that preeclamptic women from rural Eastern Cape of South Africa have increased arterial stiffness.