Dyslipoproteinaemia in postmenopausal women with a history of eclampsia

Objective To test the hypothesis that postmenopausal women with a history o f eclampsia manifest a more high risk lipid profile than postmenopausal wom en with a history of normal pregnancy. Setting The Department of Obstetrics and Gynaecology, National University H ospital, Reykjavik, Iceland, and the Magee-Womens Research Institute, Pitts burgh, Pennsylvania, USA. Participants Thirty Icelandic women with a history of eclampsia, aged betwe en 50 and 67 years at the time of re-examination (cases) were individually matched for current age, and for age and parity at index pregnancy, to 30 u nrelated Icelandic women with a history of normal pregnancy (controls). Methods The participating women completed a health and family history quest ionnaire and underwent a physical examination. Fasting plasma low density l ipoprotein diameter, serum lipids, insulin, and glucose were measured. Results Mean low density lipoprotein size was significantly smaller and apo lipoprotein B concentration was higher in women with prior eclampsia. The p ercentage of cases receiving blood pressure medication (33%) was significan tly greater than controls (6.7%). Thirteen cases had had hypertensive compl ications in at least one other pregnancy (recurrent subgroup); postmenopaus ally, these women displayed significantly increased diastolic blood pressur es, smaller-sized low density lipoprotein, increased apolipoprotein B, decr eased high density lipoprotein(2) (HDL2) cholesterol, and increased total c holesterol : HDL cholesterol ratio compared with their controls. Fourteen c ases were normotensive in all other pregnancies (nonrecurrent); these showe d no differences from their controls. Conclusions Dyslipoproteinaemia is more prevalent among postmenopausal wome n with prior eclampsia, especially with recurrent hypertension in pregnancy , than in postmenopausal women with prior normal pregnancies.