Context Epidemiological studies indicate that gestational hypertension during pregnancy is associated with increased risk of cardiovascular disease in later life. However, it is unclear whether particular metabolic and hemodynamic characteristics are related to this risk.

Objective To investigate endothelial function, carbohydrate and lipid metabolism in healthy, normotensive women with previous pregnancy complicated by gestational hypertension (GH).

Design, Setting, and Participants Brachial artery flow-mediated dilatation (FMD, endothelium-dependent) and nitroglycerin-induced dilatation (NID, endothelium independent) were measured in 15 subjects with previous GH, and in 15 controls (CTR) with previous normal pregnancies. Lipid panel, glucose, insulin, homocysteine, and androgens were also measured.

Results FMD was significantly reduced in women with previous GH than controls (P < 0.0001), whereas NID was comparable in both groups. GH women showed increased fasting insulin (P = 0.011), insulin resistance measured by homeostasis model assessment (HOMA, P = 0.018), free fatty acids (P = 0.0018), testosterone (P = 0.0012), and decreased HDL-cholesterol (P = 0.0017) than CTR. Across all subjects FMD showed a strong independent negative correlation with testosterone and HOMA, and positive correlation with HDL-cholesterol (r = -0.60, P = 0.0003; r = -0.43, P = 0.016; r = 0.58, P = 0.0005, respectively).

Conclusions Endothelial dysfunction and early alteration of carbohydrate and lipid metabolism are present in otherwise healthy women with previous GH. These abnormalities, along with a relative hyperandrogenism, could explain, at least in part, the increased risk for cardiovascular disease in later life in these women.