Abstract
Background: Pregnancy is a cardiometabolic stressor and thus a critical period to address women's lifetime cardiovascular health (CVH). However, CVH among US pregnant women has not been characterized. Methods and Results: We analyzed cross-sectional data from National Health and Nutrition Examination Surveys 1999 to 2014 for 1117 pregnant and 8200 nonpregnant women, aged 20 to 44 years. We assessed 7 CVH metrics using American Heart Association definitions modified for pregnancy; categorized metrics as ideal, intermediate, or poor; assigned these categories 2, 1, or 0 points, respectively; and summed across the 7 metrics for a total score of 0 to 14 points. Total scores 12 to 14 indicated high CVH; 8 to 11, moderate CVH; and 0 to 7, low CVH. We applied survey weights to generate US population-level estimates of CVH levels and compared pregnant and nonpregnant women using demographic-adjusted polytomous logistic and linear regression. Among pregnant women, the prevalences (95% CIs) of ideal levels of CVH metrics were 0.1% (0%–0.3%) for diet, 27.3% (22.2%–32.3%) for physical activity, 38.9% (33.7%–44.0%) for total cholesterol, 51.1% (46.0%–56.2%) for body mass index, 77.7% (73.3%–82.2%) for smoking, 90.4% (87.5%–93.3%) for blood pressure, and 91.6% (88.3%–94.9%) for fasting glucose. The mean total CVH score was 8.3 (95% CI, 8.0–8.7) of 14, with high CVH in 4.6% (95% CI, 0.5%–8.8%), moderate CVH in 60.6% (95% CI, 52.3%–68.9%), and low CVH in 34.8% (95% CI, 26.4%–43.2%). CVH levels were significantly lower among pregnant versus nonpregnant women; for example, 13.0% (95% CI, 11.0%–15.0%) of nonpregnant women had high CVH (adjusted, comparison P=0.01). Conclusions: From 1999 to 2014, <1 in 10 US pregnant women, aged 20 to 44 years, had high CVH.
Original language | English (US) |
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Article number | e015123 |
Journal | Journal of the American Heart Association |
Volume | 9 |
Issue number | 4 |
DOIs | |
State | Published - Feb 18 2020 |
Funding
Dr Perak was supported in part by a National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI) training grant (T32HL069771), a Pediatric Physician‐Scientist Research Award from the Department of Pediatrics, Northwestern University Feinberg School of Medicine, and an NHLBI K23 award (K23HL145101). Dr Khan was supported in part by an award from the NIH/NHLBI and National Center for Advancing Translational Sciences (KL2TR001424) and an award from the American Heart Association (19TPA34890060).
Keywords
- Life's Simple 7
- cardiovascular health
- pregnancy
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine