Association of physical activity, sedentary time, and sleep with maternal vascular function in women with a history of preeclampsia

A history of preeclampsia (hxPE) is associated with persistent vascular dysfunction and elevated risk of chronic hypertension. Twenty-four-hour activity behaviors, including physical activity, sedentary time (SED), and sleep, are modifiable factors that may promote favorable vascular function and blood pressure in women with a hxPE. The primary objective of this study was to investigate the cross-sectional relations between habitual physical activity, SED, and sleep with aortic stiffness and 24-h blood pressure patterns in young women with a hxPE and healthy pregnancy controls. Participants (<i>n</i> = 68; aged 21-42 yr, 1-5 yr after delivery) wore a thigh-mounted activity monitor (activPAL) for 7 days and maintained a sleep log to assess habitual physical activity, SED, and sleep duration. Participants underwent measures of aortic stiffness (measured by carotid-femoral pulse wave velocity, CFPWV) and 24-h ambulatory blood pressure monitoring (ABPM). Women with a hxPE (<i>n</i> = 33) did not differ in physical activity, SED, or sleep compared with healthy pregnancy controls (<i>n</i> = 35). SED (β = 0.214, 95CI [0.004, 0.416]) and light-intensity physical activity (β = -0.204, 95CI [-0.397, -0.004]) were independently related to CFPWV. Frequency of sleep disturbances, but not shorter sleep duration, was associated with higher 24-h diastolic blood pressure (β = 0.258, 95CI [0.009, 0.525]). Select perceived benefits and barriers to exercise were more pronounced among women with hxPE, and benefits were associated with higher moderate-vigorous physical activity (ρ = 0.43, <i>P</i> = 0.003). Our findings link habitual activity, pregnancy history, and perceived exercise benefits with aortic stiffness and identify population and behavioral targets to improve cardiovascular health in young parous women.<b>NEW & NOTEWORTHY</b> Preeclampsia is associated with persistent vascular dysfunction and incident hypertension, but the contributing behavioral factors are unclear. We demonstrate that greater light-intensity physical activity and lower sedentary time are associated with lower aortic stiffness, and link sleep disturbances to 24-h blood pressure among women with a recent history of preeclampsia and healthy pregnancy controls. Time spent in light intensity activity and sedentary behavior may represent interventional targets to mitigate elevated cardiovascular risk in postpartum women.