Antidepressant Therapy for Improved Blood Vessel Health After Preeclampsia

Purpose

Preeclampsia is a condition in pregnancy where a woman develops high blood pressure and other complications. Women who develop preeclampsia are 4 times more likely to have heart disease later in life. They are also more likely to have depression after pregnancy. Why they are more likely to develop these conditions is not known. It may be because their blood vessels were damaged during pregnancy. Changes in blood vessel health can predict heart disease. These changes have been recorded after pregnancy in women who had preeclampsia. These changes have also been recorded in women who have depression. In the previous phase of this award, we found that women who had preeclampsia in pregnancy had changes in blood vessel health after pregnancy. We also found that if these women were taking a medicine to treat depression, their blood vessel health was normal. This could mean that treatment for depression can also increase blood vessel health in women who had preeclampsia. In this project we will study how changes in blood vessel health are related to preeclampsia and depression in women who have had both. We will also study how medicine to treat depression can improve blood vessel health after preeclampsia. We will do this by measuring how blood vessels work in women who have had preeclampsia compared to women who did not, and in women who have depression and women who do not. This will tell us more about why risk for depression and heart disease is higher in women who have had preeclampsia. It will also help us understand if medicine for depression can reduce cardiovascular disease risk after preeclampsia.

Conditions

  • Preeclampsia
  • Endothelial Function

Eligibility

Eligible Ages
Between 18 Years and 45 Years
Eligible Sex
Female
Accepts Healthy Volunteers
Yes

Inclusion Criteria

  1. -24 years old, 12 weeks - 5 years post pregnancy one of the following: 1. a history of a normal pregnancy with a current diagnosis of depression, 2. a history of a normal pregnancy without a current diagnosis of depression, 3. a history of a preeclamptic pregnancy with a current diagnosis of depression, 4) and history of preeclamptic pregnancy without a current diagnosis of depression.

Exclusion Criteria

history of cardiovascular, metabolic, and/or skin diseases current or history of tobacco/nicotine/ e-cigarette use history of gestational diabetes current antihypertensive or cholesterol-lowering medication currently pregnant allergy to materials used during the experiment (e.g. latex), known allergy to study drugs currently using SSRI medications

Study Design

Phase
Early Phase 1
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Intervention Model Description
Four groups of participants (women with a history of preeclampsia + current depression, women with a history of preeclampsia - current depression, women with a history of uncomplicated pregnancy + current depression, women with a history of uncomplicated pregnancy - current depression) complete single study visit with 4 localized intradermal microdialysis treatments.
Primary Purpose
Basic Science
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Cutaneous Vascular Response to Local Heat
All women will complete the same protocol, regardless of pregnancy history and depression status. Four intradermal microdialysis fibers will be placed in the ventral forearm for the local delivery of: (1) lactated Ringer's (control), (2) paroxetine HCl, (3) ascorbic acid, or (4) paroxetine HCl + ascorbic acid. Skin blood flow will be measured with laser-Doppler flowmetry directly over each microdialysis fiber during a standard local heating protocol to 42 degrees Celsius. Once a stable plateau in blood flow has been reached, each site is perfused with L-NAME to inhibit nitric oxide synthase. Following a post-L-NAME plateau, maximal dilation is induced by perfusing sodium nitroprusside and increasing local temperature to 43 degrees Celsius.
  • Drug: Paroxetine Hydrochloride
    Localized delivery of paroxetine HCl to the cutaneous microvasculature via intradermal microdialysis.
  • Drug: Ascorbic acid (Vitamin C)
    Localized delivery of ascorbic acid to the cutaneous microvasculature via intradermal microdialysis.

Recruiting Locations

University of Iowa
Iowa City, Iowa 52242-3521
Contact:
Anna Stanhewicz
319-467-1732
anna-stanhewicz@uiowa.edu

More Details

Status
Recruiting
Sponsor
Anna Stanhewicz, PhD

Study Contact

Anna Reid-Stanhewicz, PHD
319-467-1732
anna-stanhewicz@uiowa.edu