IJCS | Volume 31, Nº4, July / August 2018

DOI: 10.5935/2359-4802.20180033 359 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2018;31(4)359-366 Mailing Address: Rafael Alessandro Ferreira Gomes Rua dos Palmares, s/n, Santo Amaro. Postal Code: 50100-060, Recife, PE - Brazil. E-mail: rafaelgomes@cardiol.br Carotid Atherosclerosis in Pre- and Post-Menopausal Women with a History of Pregnancy-Induced Hypertension: Case-Control Study Rafael Alessandro Ferreira Gomes, Isly Maria Lucena de Barros, Moacir de Novaes Lima Ferreira, Laura Olinda Bregieiro Fernandes Costa Universidade de Pernambuco (UPE), Recife, PE - Brazil Manuscript received on July 10, 2017, revised manuscript received on November 18, 2017, accepted on December 20, 2017. Abstract Background: Cardiovascular diseasemortality amongwomen remains high. Observational studies are controversial about the participation of a history of gestational hypertensive disorder in cardiovascular risk. Objective: To verify the association between carotid atherosclerosis in menopausal women who had pregnancy- induced hypertension. Methods: Case-control study, with cases consisting of women with carotid atherosclerosis, defined as carotid intima-media thickness > 1 mm and/or presence of carotid plaques; the controls did not have these alterations. The significance level was set at 95%. Results: A total of 504 women without previous cardiovascular disease were assessed, 126 cases and 378 controls. Of the total, 67% were hypertensive; 76% were dyslipidemic; and 16% were diabetic. Approximately 10% reported a history of hypertension during pregnancy. Women with carotid atherosclerosis had higher values of systolic blood pressure (134.18 mmHg vs. 128.59 mmHg, p = 0.008) and LDL-cholesterol (156.52 mg% vs. 139.97 mg%; p = 0.0005). No statistical difference was found regarding the presence of carotid atherosclerosis and history of hypertension during pregnancy (OR 1.672, 95% CI: 0.883-3.131). Conclusion: The history of hypertension during pregnancy was not associated with subclinical carotid atherosclerosis in menopausal women. However, an association was observed between carotid atherosclerosis and classic risk factors, such as elevated systolic blood pressure and LDL-cholesterol levels. (Int J Cardiovasc Sci. 2018;31(4)359-366) Keywords: Carotid Artery Diseases/physiopathology; Hypertension, Pregnancy-Induced; Women, Premenopause; Postmenopause; Case-Control Studies. Introduction Cardiovascular diseases (CVD) are the leading cause of death among women worldwide. 1,2 In the United States, they account for almost a third of all causes of death in the female gender, 3,4 and similar data are observed in Europe 5 and in Brazil. 6 Advances in CVD treatment in the last three decades have allowed a sustained decrease in mortality. However, socioeconomic and behavioral aspects have interrupted this process in recent years. 7 In 2014, there were 340,284 CVD deaths among Brazilian women, representing an increase of almost 20% in relation to those occurring 10 years earlier. 6 The cardiovascular risk stratification in the female population has failed to detect and prevent the disease. The exploration of new risk factors thus becomes essential to reduce such indices. Pregnancy is an important moment to evaluate women’s cardiovascular health, since the development of complications during this period may indicate an increase in future cardiovascular risk. 8 Several observational studies have shown a higher prevalence of atherosclerosis in women with a history of gestation- induced hypertension, 9-11 and some have observed an association between the number of cardiac events and