Abstract

Introduction: Women with a history of preeclampsia (hxPE) are at a four-fold increased risk for chronic hypertension and have elevated aortic stiffness compared withhealthy pregnancy (HP). Higher sedentary time (ST) is related to higher odds of hypertension in clinic among young women regardless of the amount of moderate-to-vigorous physical activity (MVPA). As pregnancy and postpartum are uniquely vulnerable times of increased sedentary behavior, the objectives of this study were to determine whether ST is associated with higher blood pressure (BP) and aortic stiffness in women with hxPE compared with HP 1-3 years postpartum, and if change in ST from late pregnancy to postpartum is related to change in BP or aortic stiffness. Methods: Women with hxPE (N=33) and HP (N=46) completed the Pregnancy Physical Activity Questionnaire (PPAQ) 18±6 months postpartum. BP was assessed in triplicate in clinic and by 24-hour ambulatory blood pressure monitoring and aortic stiffness by carotid-femoral pulse wave velocity (CFPWV). In a subset of women (N=20), clinic BP, CFPWV and the PPAQ were previously evaluated in the third trimester. Results: Women with hxPE reported more leisure-time ST compared with HP (18 [7-19] vs 7 [5-7] MET-hr/wk, P<0.001), whereas MVPA did not differ (77 [39-106] vs 56 [35-88] MET-hr/wk, P=0.13). 24-hour ambulatory BP was higher in women with hxPE (120 [114-126] vs 114 [109-120] mmHg, P=0.049; 78 [72-82] vs 74 [70-77] mmHg, P=0.056), but CFPWV did not differ independently of BP (6.1 vs 5.5 m/s, P=0.33). Postpartum ST, but not MVPA, was associated with higher 24-hr systolic (ρ=0.24, P=0.04) and diastolic BP (ρ=0.27, P=0.02) and higher CFPWV (ρ=0.31, P=0.008) independent of body mass index. Increases in ST from late pregnancy to postpartum (0 [-3-2] ΔMET-hr/wk, P=0.22) was related to increased BP (systolic ρ=0.42, P=0.06; diastolic ρ=0.44, P=0.050) and increases in CFPWV (ρ=0.54, P=0.02) despite a reported increase in MVPA (21.5 [-0.5-63] ΔMET-hr/wk, P=0.04). Conclusions: Greater ST is related to higher BP and aortic stiffness 1-3 years postpartum, and women with hxPE report greater leisure-time ST compared with HP controls. Reduction in ST may represent an achievable interventional strategy to improve cardiovascular health in women with hxPE.

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