New research suggests that tracking blood pressure changes during pregnancy could help predict a woman’s risk of developing high blood pressure (hypertension) in the years after giving birth.
The study found that women whose blood pressure remained stable but did not dip in mid-pregnancy had a significantly higher chance of developing hypertension later—despite having blood pressure levels considered normal during pregnancy.
The research, published in the Journal of the American College of Cardiology: Advances, followed 854 women from pregnancy through five years postpartum.
Researchers mapped their blood pressure changes and found three main patterns:
- Low and stable blood pressure (80.2%) – These women had no significant changes and were at the lowest risk of future hypertension.
- High blood pressure with a mid-pregnancy drop (7.4%) – Their blood pressure started high, dropped in the second trimester, then rose again. These women were already considered high-risk due to conditions like preeclampsia.
- Slightly elevated blood pressure with no mid-pregnancy drop (12.4%) – These women had blood pressure in the normal range but without the usual second-trimester dip. They were 4.91 times more likely to develop hypertension within five years after childbirth compared to the low-blood-pressure group.
The women in the third group would not usually be flagged as high-risk since their blood pressure remained within normal limits.
However, their increased risk suggests that simply staying within clinical guidelines isn’t enough—monitoring patterns over time may be key to early detection and prevention of heart disease.
“This group of women wouldn’t be identified as having a higher risk under current guidelines,” said Dr. Shohreh Farzan, the study’s senior author from the Keck School of Medicine at USC. “But tracking blood pressure changes during pregnancy could help us find and support them before problems arise.”
A critical time for women’s heart health
The study highlights a gap in medical research: the period between pregnancy and menopause. While heart disease is a leading cause of death in women, many pregnancy-related risk factors go unnoticed until much later in life.
The American Heart Association and the American College of Obstetricians and Gynecologists are now paying more attention to these long-term risks.
Lead author Dr. Zhongzheng (Jason) Niu, an assistant professor at the University at Buffalo, emphasized that simple changes in clinical practice—such as monitoring blood pressure patterns instead of just single readings—could help identify at-risk women early. Future research will explore whether environmental factors, like air pollution and chemicals, influence these blood pressure patterns.
What can be done?
Doctors may need to track blood pressure trends more closely during pregnancy and follow up with women whose pressure does not dip in the second trimester. The American Heart Association may also consider updating its guidelines for pregnancy-related hypertension risk.
Understanding these patterns could lead to earlier interventions, helping more women avoid high blood pressure and heart disease in the years after giving birth.
