A large new study has found that blood pressure patterns observed in the first half of pregnancy—even among women who do not develop pregnancy-related high blood pressure—can predict the risk of developing hypertension up to 14 years after childbirth.
The findings, published in the journal Hypertension, suggest that early pregnancy may hold important clues about a woman’s long-term heart health.
High blood pressure (hypertension) is a major risk factor for heart disease, the leading cause of death worldwide. Doctors already know that women who develop hypertensive disorders of pregnancy (HDP), such as preeclampsia or gestational hypertension, have an increased risk of cardiovascular disease later in life.
But this new study shows that even women who have normal pregnancies may face hidden risks based on how their blood pressure behaves in early pregnancy.
Researchers from Kaiser Permanente Northern California analyzed health records from over 174,000 women who received prenatal care between 2009 and 2019. All participants were healthy before pregnancy, with no history of high blood pressure, heart, liver, or kidney disease. They were followed for up to 14 years after giving birth to track who developed high blood pressure later on.
The researchers focused on blood pressure readings from the first 20 weeks of pregnancy and found that patterns over time—known as blood pressure trajectories—could be grouped into six categories, ranging from ultra-low to elevated-stable.
Women in the elevated-stable group had consistently higher blood pressure readings during early pregnancy, even though the levels did not meet the threshold for a diagnosis of HDP.
The results showed that these early patterns mattered—a lot. Women with elevated-stable blood pressure patterns who did not develop HDP were still 11 times more likely to develop high blood pressure later in life than women with ultra-low or low-stable blood pressure patterns.
This means that even without pregnancy complications, women with certain early blood pressure trends could face serious heart risks in the future.
Importantly, this group of women is not currently considered at high risk for heart disease under current medical guidelines. The researchers believe that early blood pressure patterns could be used to identify these women for closer monitoring and earlier lifestyle or medical interventions after pregnancy—potentially preventing future heart problems.
The study also confirmed that when early pregnancy blood pressure patterns are combined with a history of HDP, risk prediction becomes even stronger. This adds a valuable layer to existing tools for identifying women most likely to develop cardiovascular disease.
In summary, the study offers a new way to assess heart health risks in women by paying closer attention to how blood pressure behaves early in pregnancy. These findings highlight the importance of prenatal care not only for pregnancy outcomes but also for long-term health.
With this knowledge, doctors may be able to offer more personalized follow-up care and prevention strategies for women after childbirth—whether or not they had complications during pregnancy.
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The research findings can be found in Hypertension.
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