Non-invasive vascular assessment in gestational hypertension and preeclampsia during pregnancy and the postpartum period: a systematic review.
Sarah E Alkhurainej, Faisel Khan, Colin E Murdoch
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In 30 seconds
This systematic review evaluated non-invasive measures of vascular structure and function in women with gestational hypertension or preeclampsia during pregnancy and postpartum. It included 49 studies involving 32,683 participants, with findings synthesized narratively because of substantial methodological heterogeneity. Overall, studies generally reported increased arterial stiffness, impaired endothelial function, and greater intima-media thickness. Some abnormalities persisted from weeks to years after delivery, but results were inconsistent. The review concluded that these assessments identify vascular abnormalities, while evidence is insufficient to establish them as independent predictors of future cardiovascular events.
Key findings
- The review included 49 studies involving 32,683 participants; heterogeneity led to narrative rather than quantitative synthesis.
- Studies generally found increased arterial stiffness, reduced flow-mediated dilation, and increased intima-media thickness during pregnancy and postpartum.
- Some vascular abnormalities persisted from weeks to years after delivery, although findings were inconsistent.
- Evidence was insufficient to support these measures as independent predictors of future cardiovascular events.
Why it matters
The findings indicate that gestational hypertension and preeclampsia are associated with measurable macrovascular, microvascular, and endothelial abnormalities, some of which may persist after delivery. This supports interest in postpartum vascular health, while the inconsistent evidence and lack of established prognostic value mean these measures cannot yet be interpreted as reliable predictors of later cardiovascular events.
What to keep in mind
Study and measurement heterogeneity prevented quantitative synthesis, and findings on persistence were inconsistent. The review reports insufficient evidence to establish independent prediction of future cardiovascular events.