biostudies-literatureDodds LVNHLBI NIH HHS1696-1704https://www.ebi.ac.uk/biostudies/studies/S-EPMC12372538biostudies-literatureUnknown82(10)<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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; <i>P</i><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.<h4>Conclusions</h4>Lower prepregnancy cardiovascular health is an independent risk factor for HDP. Improving cardiovascular health may reduce HDP risk.Hypertension (Dallas, Tex. : 1979)Lower Prepregnancy Cardiovascular Health is Associated With Hypertensive Disorders of Pregnancy: The CARDIA Study.PMC12372538F31 HL165894Bello NAElfassy TGunderson EPKiefe CIDodds LVRundek TPaidas MJKulandavelu SFeaster DJfalseLower Prepregnancy Cardiovascular Health is Associated With Hypertensive Disorders of Pregnancy: The CARDIA Study.<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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; <i>P</i><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.<h4>Conclusions</h4>Lower prepregnancy cardiovascular health is an independent risk factor for HDP. Improving cardiovascular health may reduce HDP risk.2025-01-01T00:00:00Z2025 Oct2026-06-01T13:51:54.479Z2026-04-08T13:05:07.395ZS-EPMC123725384077688110.1161/hypertensionaha.124.2451710.1161/HYPERTENSIONAHA.124.24517