Lipid ratios improve early detection of atherosclerotic cardiovascular disease in women with hypertensive disorders in pregnancy

Year 2022, Volume: 39 Issue: 2, 353 - 358, 18.03.2022

Kenneth Atoe Ejuoghanran Onovughakpo-sakpa

Abstract

In a normal healthy pregnancy,increased lipid profiles helpto encourage fetal development, but in hypertensive disorders in pregnancy, these changes in lipid profiles are amplified, which may predispose these women to atherosclerotic cardiovascular disease. The study's aim was to determine the alteration in lipid profile levels of women with hypertensive disorders in pregnancy and also calculate their atherogenic risk ratios, with the view to improving the predictive capacity of the lipid assay for the risk of arteriosclerosis and cardiovascular incidence. This study enlisted 190 participants, which included 124 pregnant women with preeclampsia, 30 pregnant women with pregnancy-induced hypertension, and 36 pregnant women with normal blood pressure who served as controls. Lipid profile was determined via the enzymatic method from blood samples obtained from the participants. When compared to normotensive control study participants, patients with hypertensive disorders in pregnancy had a slight increase in total cholesterol and LDL cholesterol, as well as a substantial difference in triglyceride levels.Despite minor increases in total and LDL cholesterol levels, the case group's mean atherogenic index plasma, atherogenic coefficient, and Castelli risk index I and II were all higher than the control group's. Individual lipid parameter measurements were found to be ineffective in evaluating the relative contribution of lipids to cardiovascular risk in pregnant patients with hypertensive disorders. Lipid ratios, also known as atherogenic indices, were found to be more effective in assessing the relative contribution of lipids to cardiovascular risk.

Keywords

Dyslipidemia, Atherogenic indices, Hypertensive disorders in pregnancy, Preeclampsia, Lipid profile

References

• Abalos, E., Cuesta, C., Carroli, G., et al. (2014). Pre-eclampsia, eclampsia and adverse maternal and perinatal outcomes, a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG 2014, 121(Suppl. 1), 14–24.
• Albertini, R.J. (2001). Accumulation of somatic mutations in proliferating T cell clones from children treated for leukemia. Leukemia, 15, 1898–1905.
• Allain, C.C., Poon, L.S., Chan, C.S.G., Richmond, W., and Fu, P.C. (1974). Enzymatic determination of Total Serum Cholesterol. Clinical Chemistry, 20(4) ; 470-475.
• Audu, L.R. and Ekele, B.A. (2002). A ten-year review of maternal mortality in Sokoto, northern Nigeria. West Afr J Med., 21,74 – 76.
• Baker, A.M., Klein, R.L., Moss, K.L., et al. (2009). Maternal serum dyslipidemia occurs early in pregnancy in women with mild but not severe preeclampsia. Am J Obstet Gynecol, 201,293.e1-4.
• Banaczek, Z. and Wojeicka-Jagodzinska J. (1995). Concentration of lipids and lipoprotein in serum of women with pregnancy induced hypertension. Ginekologia Polska., 66(2).,72-75 .
• Begum, Z., Ara, I., Shah, A.B.S. (2011). Association between lipid profile and pre-eclampsia. Ibrahim Card Med J..,1(1).,41–44.
• Belo, L., Caslake, M., Gaffney, D., et al. (2001). Changes in LDL size and HDL concentration in normal and preeclamptic pregnancies. Atherosclerosis.,162.,425-32.
• Brizzi, P., Tonolo, G., Esposito, F., et al. (1999). Lipoprotein metabolism during normal pregnancy. Am J Obstet Gynecol.,181.,430 - 434.
• Cunningham, F.G., Leveno, K.J., Bloom, S.L., Hauth, J.C., Rouse, D.J., Catherine, Y.S. (2010). Williams Obstetrics. 23rd ed. New York., Mc Graw Hill Companies; Chapter., Hypertensive disorders in pregnancy; pp. 706–56.
• De, J., Mukhopadhyay, A.K., Saha, P.K. (2006). Study of serum lipid profile in pregnancy induced hypertension. Indian Journal of Clinical Biochemistry., 21(2).,165–68.
• Dobiasova, M. and Frohlich, J. (2001). The plasma parameter log (TG/HDL-C) as an atherogenic index.,correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FERHDL) Clinical Biochemistry., 34.,583–88.
• Dutta, D.C. and Konar, H.L. (2001). Hypertensive disorders in pregnancy., In., Textbook of Obstetrics. 5th ed., New Central Book Agency;
• Emuveyan, E. (1995). Pregnancy induced hypertension. Trop J Obstet Gynaecol. 12., 8–11.
• Enquobahrie, D.A., Williams, M.A., Butler, C.L., et al. (2004). Maternal plasma lipid concentrations in early pregnancy and risk of preeclampsia. Am J Hypertens., 7.,574 - 581.
• Itam, I.H. and Ekabule, J.E. (2002). A review of pregnancy outcome in women with eclampsia at the University of Calabar Teaching Hospital., Calabar. Trop J Obstet Gynaecol. 18.,66–68.
• Myers, J.E. and Baxer, P.N. (2002). Hypertension diseases and eclampsia. Curr Opin Obstet Gynecol..,14.,119–25.
• Noubiap, J.J., Bigna, J.J., Nyaga, U.F., et al. (2019). The burden of hypertensive disorders of pregnancy in Africa., a systematic review and meta-analysis. J Clin Hypertens., 21(4)., 479–488.
• Pushparaj, J.L., Subramanyam, G. (2012). Dyslipidemia in pre-eclampsia-risk factor for future maternal cardiovascular diseases. Journal of Evolution of Medical and Dental Sciences., 1(4).,487–95.
• Sattar, N., Clark, P., Greer, I.A. et al. (2000). Lipoprotein (a) levels in normal pregnancy and in pregnancy complicated with preeclampsia. Atherosclerosis.,148 (2)., 407-411.
• Steer, P.J. (2001). Turnbull’s Obstetrics. Geoffrey Chamberlain., 3rd Edition. Churchill., Livingstone.
• Third report of the National Cholesterol Education Program (NCEP) (2002). expert panel on Detection., Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. National Cholesterol Education Program. [online] 2002 Sep. Available from., URL., http.,//www.nhlbi.nih.gov/guidelines/ cholesterol/atp3full.pdf.