Novel coronary heart disease markers many years after hypertensive pregnancy

Abstract

Objective: We aimed to assess if markers of coronary heart disease (CHD), including lipoprotein (a), fibrinogen level and LDL particle size, are elevated in women with hypertensive pregnancy (HP) history. Our previous work showed an increase in homocysteine and C-reactive protein in these women. Fibrinogen, LDL particle size and lipoprotein (a)have been linked to CHD.The role of these markers in identifying women who may be at increased risk of CHD is unclear. Methods: Lipoprotein(a), fibrinogen and LDL particle size were measured in 218 nulliparous women, 1,849 women with a history of a normotensive pregnancy and 408 women with a history of hypertensive pregnancy who participated in the Genetic Epidemiology Network of Arteriopathy (GENOA) study. Non-Hispanic white (n=703, 28%), non-Hispanic black (n=1,038, 42%) and Hispanic (n=734, 30%) women were examined at 60±11 years of age.These markers were measured a mean of 30±12 years after the first hypertensive pregnancy. Mean levels of markers were compared between pregnancy groups using linear regression models adjusted for race, age, education, smoking, hypertension, diabetes, BMI, dyslipidemia and family history of CHD or hypertension. Results: History of HP was associated with an 11% increase in lipoprotein (a) levels compared to normotensive pregnancy (p=0.049). There was a trend towards higher mean fibrinogen levels in women with a history of HP compared to normotensive pregnancy, (361±80 vs. 354±80, p=0.10) Log lipoprotein a linear model (n=2437) Conclusion: History of HP is associated with significant increase in lipoprotein (a), which has a significant role in atherosclerosis and the development CHD. Fibrinogen levels and LDL particle size did not show a similar significant difference.