POSTPARTUM BLOOD-PRESSURE AND INSULIN SENSITIVITY IN AFRICAN-AMERICANWOMEN WITH RECENT PREECLAMPSIA

Pregnancy-induced hypertension and preeclampsia are relatively common in nulliparous, inner-city, African-American, pregnant women and contr ibute to considerable maternal, fetal, and neonatal morbidity and mort ality in that population. Recently, insulin resistance has been relate d to the development of hypertension in young African-Americans and hy perinsulinemia and elevated insulin-to-glucose ratios, suggesting insu lin resistance, have been demonstrated in women with preeclampsia. To investigate whether insulin resistance existed postpartum and, therefo re, independently of the pregnant state, the hyperinsulinemic, euglyce mic technique was used 3 to 6 months postpartum to assess insulin sens itivity in 10 young, black, primiparous, inner-city women with recent preeclampsia and seven age-, weight- and body-mass-index-matched black women with healthy pregnancies. The age, weight, body-mass index, wai st-to-hip ratio, the duration since parturition, and fasting plasma gl ucose and insulin were similar in the preeclamptic and control groups. During the clamp procedure, the insulin levels and mean diastolic blo od pressure and mean arterial pressure were also similar for both grou ps; however, the mean systolic blood pressure of the preeclamptic grou p (123 +/- 3 mm Hg) was higher than that of the control group (114 +/- 2 mm Hg) (P < .05). Insulin-stimulated glucose disposal was not diffe rent between the preeclamptic (5.6 +/- 0.3 mg/kg/min) and control grou ps (5.7 +/- 0.7 mg/kg/min). This suggests that the elevation in postpa rtum systolic blood pressure may reflect a persistent abnormality of b lood pressure homeostasis which is not associated with insulin resista nce.