Vascular endothelial function is preserved in women with a history of preeclampsia currently receiving antidepressant pharmacotherapy

Women with a history of preeclampsia (hxPE) have an elevated risk of cardiovascular disease, likely in part from reduced endothelial function. Preeclampsia is also associated with increased risk of depression. Although evidence indicates that antidepressant pharmacotherapy may have vasculoprotective effects, it is unclear whether it preserves endothelial function in women with hxPE. We hypothesized that antidepressant-treated women with hxPE would have preserved endothelial function compared with unmedicated women with hxPE. Ten women with hxPE currently treated with an antidepressant (hxPE + AD), 10 not treated (hxPE - AD), and 10 unmedicated women with a history of uncomplicated pregnancy (HC) participated. Macrovascular endothelial function was measured via brachial artery flow-mediated dilation (FMD). Microvascular endothelial function and the nitric oxide (NO) component were assessed via cutaneous vascular conductance (CVC; %max) responses to graded infusions of acetylcholine (10^-10-10^-1 M) alone or with 15 mM <i>N</i>^G-nitro-l-arginine methyl ester (L-NAME; NO-synthase-inhibitor), respectively. Relative and absolute FMD in hxPE - AD were lower compared with HC (5.7 ± 0.3% vs. 7.5 ± 0.3%, <i>P</i> = 0.02; 0.18 ± 0.01 mm vs. 0.23 ± 0.01 mm, <i>P</i> = 0.02) and hxPE + AD (vs. 7.2 ± 0.6% and 0.23 ± 0.02 mm, both <i>P</i> ≤ 0.047). hxPE - AD had reduced microvascular endothelium-dependent vasodilation responses to acetylcholine compared with HC (<i>P</i> = 0.017). Peak CVC in hxPE - AD was lower than in HC (82.0 ± 2.9%max vs. 96.2 ± 2.0%max, <i>P</i> < 0.01) and hxPE + AD (vs. 92.3 ± 3.4%max, <i>P</i> = 0.04). L-NAME reduced microvascular dilation in all groups (<i>P</i> < 0.001). NO-dependent dilation did not differ among groups (<i>P</i> = 0.07). Collectively, macrovascular and microvascular endothelial function in hxPE + AD was greater than hxPE - AD and did not differ from HC, suggesting that antidepressant pharmacotherapy may preserve endothelial function in women with hxPE.<b>NEW & NOTEWORTHY</b> To our knowledge, this is the first study to demonstrate that chronic antidepressant use is associated with preserved endothelial function in women with a history of preeclampsia (hxPE). Compared with healthy controls, untreated women with hxPE had reduced macrovascular (brachial artery) and microvascular (cutaneous) endothelial function, whereas those treated with antidepressants exhibited preserved endothelial function. These findings suggest that antidepressants may modulate persistent endothelial dysfunction in these women following preeclampsia.