OBJECTIVE: To test the hypothesis that postmenopausal women with a history of eclampsia manifest a more high risk lipid profile than postmenopausal women with a history of normal pregnancy. SETTING: The Department of Obstetrics and Gynaecology, National University Hospital, Reykjavik, Iceland, and the Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA. PARTICIPANTS: Thirty Icelandic women with a history of eclampsia, aged between 50 and 67 years at the time of re-examination (cases) were individually matched for current age, and for age and parity at index pregnancy, to 30 unrelated Icelandic women with a history of normal pregnancy (controls). METHODS: The participating women completed a health and family history questionnaire and underwent a physical examination. Fasting plasma low density lipoprotein diameter, serum lipids, insulin, and glucose were measured. RESULTS: Mean low density lipoprotein size was significantly smaller and apolipoprotein B concentration was higher in women with prior eclampsia. The percentage of cases receiving blood pressure medication (33%) was significantly greater than controls (6.7%). Thirteen cases had had hypertensive complications in at least one other pregnancy (recurrent subgroup); postmenopausally, these women displayed significantly increased diastolic blood pressures, smaller-sized low density lipoprotein, increased apolipoprotein B, decreased high density lipoprotein2 (HDL2) cholesterol, and increased total cholesterol: HDL cholesterol ratio compared with their controls. Fourteen cases were normotensive in all other pregnancies (nonrecurrent); these showed no differences from their controls. CONCLUSIONS: Dyslipoproteinaemia is more prevalent among postmenopausal women with prior eclampsia, especially with recurrent hypertension in pregnancy, than in postmenopausal women with prior normal pregnancies.
In men without any symptoms of ischemic heart disease, living in two different geographical zones (Moscow and Chuckchee land) low level of high density lipoprotein (HDL) cholesterol was accompanied by alterations in phospholipid composition of HDL2 and HDL3: decrease in the ration of lecithin and increase in sphingomyelin and kephalin content. The alteration in the phospholipid composition of these two HDL subclasses occurred simultaneously with changes in fatty acid composition of HDL lecithin: decrease in the ratio of linoleic acid as well as in stearic and arachidonic or eucosepentaenic acids. At the same time, phospholipid composition of the HDL subclasses was dissimilar in men and women without any symptoms of ischemic heart disease. Role of alterations in the fatty acid composition of phosphatide acid as well as effect of hormones on alterations in the phospholipid composition of HDL in hypoalphacholesterolemia are discussed.
