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

作者：Leah V. Dodds, Daniel J. Feaster, Catarina I. Kiefe, Erica P. Gunderson, Natalie A. Bello, Tatjana Rundek, Michael J. Paidas, Shathiyah Kulandavelu, Tali Elfassy · 发表于：Hypertension · 年份：2025 · DOI：10.1161/hypertensionaha.124.24517 · 被引用次数：3 · 研究领域：Pregnancy and preeclampsia studies、Gestational Diabetes Research and Management、Cardiovascular Health and Risk Factors

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 (n BlackWomen =1480; n WhiteWomen =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...