Protective Role of Prenatal Aspirin Use Against Persistent Endothelial Dysfunction in Postpartum Women with a History of Preeclampsia

Women with a history of preeclampsia (hxPE) are at a higher risk of developing cardiovascular disease and related mortality later in life. This association between preeclampsia and chronic cardiovascular risk may be mediated by persistent endothelial dysfunction following preeclampsia. Low-dose aspirin (LDA; 75-150mg/day) is commonly recommended during high-risk pregnancy to reduce preeclampsia incidence and severity and may also help stabilize endothelial function. We hypothesized that LDA use during pregnancy preserves macrovascular and microvascular endothelial function in postpartum women with hxPE. We included three groups: women with hxPE treated with prenatal LDA (hxPE+LDA; n=6; 34±3 years), women with hxPE not treated with prenatal LDA (hxPE-LDA; n=10; 34±2 years), and women with a history of uncomplicated pregnancy (HC; n=10; 35±2 years). Conduit artery endothelial function was assessed via brachial artery flow-mediated dilation (FMD). Microvascular endothelial function was assessed via cutaneous vascular conductance (CVC, %max) response to graded infusions of acetylcholine (10 -10 -10 -1 M) via microdialysis. Relative and absolute FMD in hxPE-LDA were lower compared to HC (relative: 6.0±0.5% vs. 7.7±0.4%, P =0.04; absolute: 0.19±0.01mm vs. 0.24±0.01mm, P =0.01), while hxPE+LDA did not show a difference from HC (relative: 6.3±0.5% vs. 7.7±0.4%, P =0.16; absolute: 0.21±0.01mm vs. 0.24±0.01mm; P =0.27). hxPE-LDA exhibited reduced microvascular endothelium-dependent dilation compared to HC at acetylcholine doses ≥10 -3 M ( P <0.03). hxPE+LDA also showed reduced endothelium-dependent dilation compared to HC, but only at 10 -3 M ( P <0.01). Peak CVC response to acetylcholine in hxPE-LDA was lower than HC (79±5%max vs. 94±4%max, P =0.04), but no significant difference was observed between hxPE+LDA and HC (93±4%max vs. 94±4%max, P =0.99). These findings suggest that prenatal LDA therapy may reduce persistent vascular endothelial dysfunction after pregnancy in women with hxPE. American Heart Association CDA 937990 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.