The stress reactivity hypothesis (SRH) posits highly stressful early environments contribute to exaggerated cardiovascular (CV) reactivity and/or slower CV recovery, which in turn contributes to CV disease. These associations are well-supported in the literature; however, a growing number of studies have revealed conflicting associations. These results may be explained by the Biological Sensitivity to Context theory (BSCT), which proposes a U-shaped relationship between stress and support in the early environment and CV reactivity. The three distinct sensitivity patterns in the BSCT have been associated with differing affective and behavioral outcomes and may be similarly associated with differing disease risk. However, few studies have appropriately examined the BSCT in adult samples and few, if any, have examined whether the associations proposed by the BSCT are associated with intermediate markers of disease risk. The current study sought to examine the BSCT using appropriate analyses, determine whether the associations between early environment stress and CV responses were better explained by the BSCT or SRH, and determine whether the associations proposed by the SRH and BSCT are associated with sleep health, a robust predictor of CV disease. Participants were 213 adults who participated in the Pittsburgh Common Cold Study 3. The results of stepwise linear regression and mediation analyses provided little support for the SRH. In contrast, stepwise linear regression analyses revealed the hypothesized U-shaped relationship between care and support in parental bonds and mean arterial pressure (MAP) reactivity. Further, moderation analyses revealed a positive effect of care and support in parental bonds on sleep duration and sleep efficiency for individuals who displayed high MAP reactivity. The sample used in the current study is more gender-balanced, older on average, and has lower income levels than any previous investigation revealing the U-shaped relationship proposed by the BSCT. The results of moderation analyses provide perhaps the first evidence the BSCT sensitivity profiles are associated with differing disease risk. Finally, the current study highlights the need for future studies comparing the associations between early experiences, CV responses and disease risk between multiple empirical frameworks, and supports the use of the BSCT as one such framework.