Central adiposity worsening vascular health in young women with preeclampsia history

Objective: Cardiovascular disease (CVD) remains the leading cause of mortality and is often underestimated in women, particularly in those with a history of preeclampsia (PE). Obesity has increased every year, with countries being unsuccessful in reducing its prevalence. This study aimed to evaluate cardiovascular outcomes in women aged less than 40 years old, considering both PE history and central adiposity (CA). Methods: We conducted a retrospective case–control study using data from a Brazilian cohort initiated in 1978/1979, with follow-up in 2016/2017. Of the 1775 individuals evaluated, 929 were women, and 188 reported their PE history. Women were categorized as having PE history or no PE history (CTL) and further classified by the presence of CA (waist circumference ≥88 cm). Cardiovascular events, blood pressure, and arterial stiffness were also recorded. Results: Hypertension was present in 66.7 and 69.7% of women with PE_CA and PE_noCA, respectively. The risk was 19-fold higher in PE_CA and 24-fold higher in PE_noCA than in CTL_noCA. Conditional inference tree (CTree) analysis confirmed that PE preeclampsia ( P < 0.0001) was the strongest determinant of hypertension, followed by CA ( P < 0.0001) and dyslipidemia ( P = 0.019). CA significantly worsened SBP [24-h ambulatory blood pressure monitoring (ABPM) +15.6 mmHg; daytime ABPM +15.9 mmHg; office + 15.3 mmHg] and increased pulse wave velocity (PWV) by 1.14 m/s among women with history of PE. Conclusion: PE significantly increased the cardiovascular risk, with CA further exacerbating vascular impairment. Early cardiovascular risk assessment and prevention strategies are essential for young women with a history of PE to prevent future cardiovascular events.