Lower Prepregnancy Cardiovascular Health is Associated With Hypertensive Disorders of Pregnancy: The CARDIA Study.

IF 8.2 1区医学 Q1 PERIPHERAL VASCULAR DISEASE

Hypertension Pub Date : 2025-08-08 DOI:10.1161/hypertensionaha.124.24517

L V Dodds,D J Feaster,C I Kiefe,E P Gunderson,N A Bello,T Rundek,M Paidas,S Kulandavelu,T Elfassy

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Abstract

BACKGROUND Hypertensive disorders of pregnancy (HDP), including gestational hypertension, preeclampsia, and eclampsia, contribute to increased maternal morbidity and mortality and long-term cardiovascular disease risk. It is unclear whether HDP arises from pregnancy-specific complications or preexisting maternal cardiovascular traits unmasked during pregnancy. This article evaluates whether cardiovascular health before pregnancy, assessed by the American Heart Association's Life's Essential 8 (LE8) score, is associated with HDP risk. METHODS The CARDIA (Coronary Artery Risk Development in Young Adults) is a longitudinal cohort study of 5115 Black and White men and women, aged 18 to 30 years at baseline (1985-1986), and followed for over 30 years (nBlackWomen=1480; nWhiteWomen=1307). The LE8 score (range, 0-100) was calculated using health behaviors (diet, smoking, physical activity, sleep) and clinical metrics (body mass index, blood pressure, cholesterol, glucose). Cardiovascular health was categorized as low (LE8 <50), moderate (LE8 50-79), or high (LE8 ≥80). HDP was self-reported as gestational hypertension, preeclampsia, or eclampsia in pregnancies lasting ≥23 weeks. Generalized mixed models assessed the association between LE8 and HDP among 2036 pregnancies from 1227 women, adjusting for age, time-varying parity, education, income, follow-up time, cumulative births, and multiple gestation. RESULTS Mean baseline age was 24.1 years, 48.7% were Black women, and 19.9% reported HDP. Women with HDP had lower baseline LE8 scores (77.0 versus 79.5; P<0.01). Compared with high cardiovascular health, moderate (odds ratio, 1.78 [95% CI, 1.13-2.81]) and low cardiovascular health (odds ratio, 3.95 [95% CI, 1.05-14.88]) were associated with increased HDP risk. CONCLUSIONS Lower prepregnancy cardiovascular health is an independent risk factor for HDP. Improving cardiovascular health may reduce HDP risk.

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低孕前心血管健康与妊娠高血压疾病相关：CARDIA研究

妊娠期高血压疾病（HDP），包括妊娠期高血压、先兆子痫和子痫，有助于增加孕产妇发病率和死亡率和长期心血管疾病风险。目前尚不清楚HDP是由妊娠特异性并发症引起的，还是由妊娠期间暴露的母体心血管特征引起的。本文评估了美国心脏协会生命基本8 （LE8）评分评估的孕前心血管健康是否与HDP风险相关。方法CARDIA（年轻成人冠状动脉风险发展）是一项纵向队列研究，5115名黑人和白人男性和女性，基线年龄为18至30岁（1985-1986），随访超过30年(nBlackWomen=1480；nWhiteWomen = 1307)。LE8评分（范围0-100）是根据健康行为（饮食、吸烟、体育活动、睡眠）和临床指标（体重指数、血压、胆固醇、葡萄糖）计算出来的。心血管健康分为低（LE8 <50）、中等（LE8 50-79）和高（LE8≥80）。HDP自我报告为妊娠期高血压、先兆子痫或妊娠期≥23周的子痫。广义混合模型评估了来自1227名妇女的2036例妊娠中LE8和HDP之间的关系，调整了年龄、时变胎次、教育程度、收入、随访时间、累计分娩和多胎妊娠。结果平均基线年龄为24.1岁，48.7%为黑人女性，19.9%为HDP。患有HDP的女性基线LE8评分较低(77.0比79.5；P < 0.01)。与高心血管健康组相比，中度（优势比1.78 [95% CI, 1.13-2.81]）和低心血管健康组（优势比3.95 [95% CI, 1.05-14.88]）与HDP风险增加相关。结论孕前心血管健康状况较差是HDP的独立危险因素。改善心血管健康可降低HDP风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hypertension 医学-外周血管病

CiteScore

15.90

自引率

4.80%

发文量

1006

审稿时长

1 months

期刊介绍： Hypertension presents top-tier articles on high blood pressure in each monthly release. These articles delve into basic science, clinical treatment, and prevention of hypertension and associated cardiovascular, metabolic, and renal conditions. Renowned for their lasting significance, these papers contribute to advancing our understanding and management of hypertension-related issues.