Blood pressure changes in early pregnancy are linked to the risk of hypertension up to 14 years later

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NIH-funded study reveals new risk group for high blood pressure and future heart disease.

What

Blood pressure patterns observed during the first half of pregnancy, even in women without hypertensive disorders of pregnancy (HDP), can identify women at increased risk of developing hypertension up to 14 years after delivery. The new findings come from a large observational study funded by the National Institutes of Health (NIH).

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High blood pressure is a risk factor for heart disease, the leading cause of death. This study identified a new, previously undefined risk group of postpartum women who are not currently recognized as being at high risk for future hypertension and cardiovascular disease because they did not develop HHT during pregnancy. HHT includes serious complications such as: preeclampsia and gestational hypertension during pregnancy and are known to increase the risk of heart disease later in life. When THG history was combined with women's blood pressure patterns in early pregnancy, these data provide a new and improved tool for risk assessment.

The study followed 174,774 women who received prenatal care at Kaiser Permanente Northern California between 2009 and 2019. None of these women had hypertension, kidney, liver, or heart disease, or a history of preeclampsia before pregnancy. The researchers tracked their medical records for up to 14 years after delivery to identify new cases of hypertension.

The research found that women who experienced certain blood pressure patterns during the first 20 weeks of pregnancy were more likely to develop hypertension later in life. Six distinct blood pressure trajectory risk groups were identified, ranging from ultra-low patterns to high-stable patterns. Women with high-stable blood pressure patterns had the highest risk.

This study shows that blood pressure trajectories in early pregnancy can stratify this risk, even for women without HDP. By identifying women at higher risk, healthcare providers can offer targeted monitoring and early interventions, potentially preventing future heart problems.

Detailed results:

• The study showed that these blood pressure patterns could differentiate risk levels between women with and without HDP.
• Among groups of women who did not develop HDP, those with higher-risk blood pressure profiles—including high and stable profiles—early in pregnancy were still 11 times more likely to develop hypertension years later than women with less risky blood pressure profiles.

The researchers suggest that this previously unrecognized risk group may warrant closer monitoring after pregnancy. Additionally, they suggest that blood pressure trajectories during early pregnancy may improve predictions of cardiovascular disease risk in women. The findings appear in the journal Hypertension.

The study was funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the NIH, through R01 HL145808 and R01 HL145808-02S1.

Who

Health experts from the NIH's National Heart, Lung, and Blood Institute are available to discuss these findings.

About the National Heart, Lung, and Blood Institute (NHLBI): The NHLBI is the world leader in conducting and supporting research on heart, lung, and blood diseases and sleep disorders, which advances scientific knowledge, improves public health, and saves lives. For more information, visit www.nhlbi.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, comprises 27 institutes and centers and is part of the U.S. Department of Health and Human Services. NIH is the primary federal agency that conducts and supports basic, clinical, and translational medical research, and studies the causes, treatments, and cures for common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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