Life’s Essential 8 and cardiovascular disease in women with a history of adverse pregnancy outcomes

Jan 31, 2025European journal of preventive cardiology

Heart health factors and heart disease risk in women who had pregnancy complications

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Abstract

Women with a high Life's Essential 8 (LE8) score had a hazard ratio of 0.43 for cardiovascular disease (CVD) compared to those with a low score over a median follow-up of 13.5 years.

Better cardiovascular health is associated with a lower long-term risk of CVD in women with a history of adverse pregnancy outcomes (APOs).
The incidence of total CVD was significantly lower in the top tertile of LE8 score among women with prior APOs.
Among women with APOs, significant reductions in coronary heart disease and atrial fibrillation were observed with higher LE8 scores.
Women with high LE8 scores and prior APOs exhibited similar long-term cardiovascular risks as those without prior APOs.

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AIMS: To assess whether better cardiovascular health (CVH) is associated with a lower long-term risk of cardiovascular disease (CVD) in women with a history of adverse pregnancy outcomes (APOs).

METHODS AND RESULTS: Using data from the UK Biobank prospective cohort, we included 2263 participants with prior APOs and 107 260 participants without prior APOs. Life's Essential 8 (LE8) score was assessed at baseline. Multivariable-adjusted Cox models were used to estimate the associations between LE8 score and CVD events. Over a median 13.5 years of follow-up, 11 134 incident CVD events were documented. Among women with prior APOs, the incidence of total CVD was significantly lower in the top tertile compared with the bottom tertile, with a hazard ratio (HR) [95% confidence interval (CI)] of 0.43 (0.29, 0.65). A similar trend was observed in women without APOs, with an HR (95% CI) of 0.55 (0.53, 0.58). With respect to the individual CVD outcomes, among women with APOs, only the associations with coronary heart disease (CHD), HR (95% CI) for T3 vs. T1: 0.30 (0.17, 0.55), and atrial fibrillation (AF): 0.47 (0.24, 0.91) achieved statistical significance. Women with high LE8 score and prior APOs had a similar long-term cardiovascular risk compared with women with high LE8 score and no prior APOs [0.95 (0.63, 1.44)].

CONCLUSION: Among women with a history of APOs, better CVH as assessed using LE8 was associated with a significantly lower incidence of CVD, particularly CHD and AF. The excess risk associated with APOs appears to be attenuated among those with a high LE8 score.

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Life’s Essential 8 and cardiovascular disease in women with a history of adverse pregnancy outcomes

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