Open AccessEarly Pregnancy Cardiovascular Health and Subclinical Atherosclerosis
Author(s) -
Benschop Laura,
SchalekampTimmermans Sarah,
Schelling Sara J. C.,
Steegers Eric A. P.,
Roeters van Lennep Jeanine E.
Publication year - 2019
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.118.011394
Subject(s) - medicine , pregnancy , obstetrics , body mass index , generation r , subclinical infection , blood pressure , cardiovascular health , early pregnancy factor , disease , postpartum period , prospective cohort study , gestation , genetics , biology
Background Assessing and optimizing cardiovascular health ( CVH ) early in life, such as in pregnancy, could lead to a longer lifetime spent in better CVH and reduce the risk of cardiovascular disease. This might especially benefit women with a hypertensive disorder of pregnancy ( HDP ) who are more likely to develop atherosclerosis and cardiovascular disease. We hypothesized that CVH in pregnancy is related to later life CVH and carotid intima‐media thickness ( CIMT ), and that these associations differ between women with a normotensive pregnancy and women with an HDP . Methods and Results This study was conducted within the prospective population‐based Generation R Study. CVH in pregnancy was based on 5 metrics (blood pressure, total‐cholesterol, glucose, smoking, and body mass index). Postpartum CVH additionally included physical activity and diet scores, according to the American Heart Association classification. Postpartum CVH and CIMT were measured 10 years after pregnancy. Results were analyzed for women with a normotensive pregnancy and those with an HDP . Women with a normotensive pregnancy (n=1786) and women with an HDP (n=138) were evaluated from early pregnancy until 10 years postpartum. Better CVH in early pregnancy was associated with a smaller CIMT and better postpartum CVH in all women, especially in those with an HDP ( CIMT : −9.82 μm [95% CI : −17.98, −1.67]). Conclusions Already in pregnancy, better CVH is associated with a smaller CIMT and better CVH 10 years postpartum, especially in women with an HDP . As pregnancy is an incentive for women to improve lifestyle, assessing CVH in pregnancy might help improve postpartum CVH and reduce cardiovascular disease risk.