Higher Backward Central Pressure and Pulse Pressure Among Women With a History of Preeclampsia: Role of Central Pulsatile Pressure Hemodynamics on Cognitive Function

Introduction: Women with a history of preeclampsia (hxPE) show reduced executive function (EF) and processing speed (PS) compared with a healthy pregnancy (HP). While central pulsatile pressure hemodynamics are associated with end-organ damage and cardiovascular disease with aging, their relation with cognitive function in postpartum women with a recent hxPE or HPs remain unknown. Therefore, we aimed to determine the differences in central pulsatile pressure hemodynamics between women with a hxPE and HP histories, and whether these central pressure hemodynamics were associated with cognitive function. Methods: Applanation tonometry and pressure-only wave separation analysis were conducted in 144 postpartum women (n=77 HP history controls and n=67 hxPE). Carotid waveforms were used to derive forward (Pf) and backward (Pb) pressure wave amplitudes, reflection coefficient (Rm = Pb/Pf), and carotid pulse pressure (PP). EF and PS scores were determined via transformation of individual test scores into Z-scores averaged across the composites. Results: Women with a hxPE had higher Pb and carotid PP compared with controls, after adjustment for body mass index (BMI) and age (both p=0.007). After adjustment for education and age, women with a hxPE had significantly lower PS compared with HP (p=0.001). There was no association between Pb or carotid PP, or other hemodynamics, and PS in women with a hxPE (all p>0.05). All models were adjusted for BMI, age, and education. Conclusion: Higher Pb, not Pf, contributes to higher carotid PP in women with a hxPE. No central pressure hemodynamic factor explained the lower PS in women with a hxPE. Funding: Funded by the American Heart Association grants 18SCG34350001 to MKS and 969732 to GLP. This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.