Variation in lipid levels during pregnancy in women with different types of hypertension

Objectives. To evaluate the levels of serum lipids (cholesterol and triglycerides) in pregnant women with different types of hypertension, at the first, second and third trimesters of pregnancy. Methods. Cholesterol and triglyceride levels at the first, second and third trimesters of gestation were recorded for 115 women with hypertension during pregnancy, and 115 healthy pregnant women matched for age and body mass index. Cases were classified as having mild gestational hypertension (25), severe gestational hypertension (15), mild preeclampsia (20), severe preeclampsia (20), chronic hypertension (20), and superimposed preeclampsia (15). Results. Cholesterol levels were not statistically different between cases and controls in any form of hypertension. At 20 and 34 weeks' gestation, triglyceride levels were significantly higher than controls in women with severe gestational hypertension, mild and severe preeclampsia, and superimposed preeclampsia, but not in mild gestational hypertension or chronic hypertension. The significant elevation in triglycerides was already present at 10 weeks in mild and severe preeclampsia. Conclusions. The data suggest that the alterations in lipid metabolism observed in preeclampsia are already present at the first trimester of pregnancy. Women with severe gestational hypertension presented a pattern of triglycerides similar to that of preeclamptic women, but mild gestational hypertension resembled chronic hypertension in this respect. This supports the concept that, although in many cases gestational hypertension represents latent essential hypertension, some of these women, probably the most severe cases, present with true pregnancy-induced hypertension, or nonproteinuric preeclampsia.