Estimated pulse wave velocity as an integrated hemodynamic risk indicator in obese women with gestational hypertension: A cross‐sectional study

Abstract

Hypertensive disorders of pregnancy are associated with increased cardiovascular risk and arterial remodeling, further complicated by obesity. While carotid-femoral pulse wave velocity remains the gold standard for arterial stiffness assessment, estimated PWV (ePWV) and carotid-radial PWV (crPWV) offer practical alternatives. This study evaluated ePWV and crPWV in gestational hypertension (GH) and their association with asymmetric dimethylarginine (ADMA). Cross-sectional analysis of 74 obese pregnant women (GH: n = 38; normotensive: n = 36). Lifestyle characteristics were assessed via WHO STEPS questionnaire. Seated blood pressure was measured and ePWV calculated. crPWV and augmentation index (AIx) were assessed using Complior Analyse. Serum ADMA was measured. Multivariable linear regression identified independent predictors of arterial stiffness, adjusting for central systolic blood pressure (cSBP), AIx, ADMA, and GH status. ePWV was significantly higher in the GH group (7.7 vs. 6.6 m/s; p < 0.001), while crPWV did not differ significantly (p = 0.14). A significant correlation between ePWV and crPWV was observed (r = 0.42; p < 0.001). ADMA did not differ between groups. cSBP and AIx independently predicted crPWV; GH status independently predicted ePWV. ADMA was not significantly associated with either marker. ePWV may serve as a practical, effective index for assessing vascular load in obese obstetric populations.