Vascular Endothelial Function Is Preserved in Women With a History of Preeclampsia Currently Receiving Antidepressant Pharmacotherapy

Am J Physiol Heart Circ Physiol. 2026 Jan 14. doi: 10.1152/ajpheart.00890.2025. Online ahead of print.

ABSTRACT

Women with a history of preeclampsia (hxPE) have elevated risk of cardiovascular disease, likely in part from reduced endothelial function. Preeclampsia is also associated with increased risk of depression. While 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^-1M) alone or with 15mM N^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%, P=0.02; 0.18±0.01mm vs. 0.23±0.01mm, P=0.02) and hxPE+AD (vs. 7.2±0.6% and 0.23±0.02mm, both P≤0.047). hxPE-AD had reduced microvascular endothelium-dependent vasodilation responses to acetylcholine compared with HC (10^-5 to 10^-2M, P=0.017). Peak CVC in hxPE-AD was lower than HC (82.0±2.9%max vs. 96.2±2.0%max, P<0.01) and hxPE+AD (vs. 92.3±3.4%max, P=0.04). L-NAME reduced microvascular dilation in all groups (P<0.001). NO-dependent dilation did not differ among groups (P=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.

PMID:41533366 | DOI:10.1152/ajpheart.00890.2025