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Whether these relationships exist for elevated blood pressure (BP) in the subclinical range is unknown. We investigated associations between (1) hypertensive disorders of pregnancy and (2) maternal BP trajectories, including in the subclinical range, and circulating EVP miRNA levels during pregnancy in the MADRES (Maternal and Developmental Risks From Environmental and Social Stressors) Study (n=372).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">Latent class trajectory modeling was used to identify trajectories from BP measures abstracted from medical records. The NanoString nCounter platform was used to quantify 798 miRNAs extracted from maternal blood (median gestational age: 31.6\u2009weeks). Covariate\u2010adjusted regression models assessed associations between each hypertensive disorders of pregnancy subtype or BP trajectory and levels of each miRNA.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Three BP trajectories were identified: Low, Moderate, and High. Chronic hypertension was associated with higher levels of miR\u20101185\u20102\u20103p (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              <jats:sub>false discovery rate<\/jats:sub>\n              &lt;0.05), a placenta\u2010specific miRNA linked to arterial stiffness and preterm delivery. Many placenta\u2010expressed miRNAs previously associated with a longer gestational duration in the same cohort were lower among participants with elevated BP (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.05). Target genes of BP\u2010associated EVP miRNAs were overrepresented in pathways involved in vascular inflammation, oxidative stress, endothelial dysfunction, and placental function.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Circulating levels of placenta\u2010expressed EVP miRNAs previously implicated in adverse birth and cardiovascular outcomes are sensitive to elevated maternal BP during pregnancy, including in the subclinical range.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.040416","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T07:16:51Z","timestamp":1749626211000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Blood Pressure and Late Pregnancy Circulating miRNAs in the MADRES Study"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1050-5470","authenticated-orcid":false,"given":"Elizabeth C.","family":"Anderson","sequence":"first","affiliation":[{"name":"Geisel School of Medicine at Dartmouth","place":["Lebanon"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4775-2133","authenticated-orcid":false,"given":"Meghan E.","family":"Muse","sequence":"additional","affiliation":[{"name":"Geisel School of Medicine at Dartmouth","place":["Lebanon"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongzheng","family":"Niu","sequence":"additional","affiliation":[{"name":"University of Southern California","place":["Los Angeles"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1314-6813","authenticated-orcid":false,"given":"Helen B.","family":"Foley","sequence":"additional","affiliation":[{"name":"University of Southern 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Dartmouth","place":["Hanover"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2508-567X","authenticated-orcid":false,"given":"Jessica L.","family":"Bentz","sequence":"additional","affiliation":[{"name":"Dartmouth\u2010Hitchcock Medical Center","place":["Lebanon"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9897-3692","authenticated-orcid":false,"given":"Shohreh F.","family":"Farzan","sequence":"additional","affiliation":[{"name":"University of Southern California","place":["Los Angeles"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0029-5641","authenticated-orcid":false,"given":"Theresa M.","family":"Bastain","sequence":"additional","affiliation":[{"name":"University of Southern California","place":["Los 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