Health
Blood pressure patterns during pregnancy predict later risk of hypertension and research findings – UBNOW: news and views from UB faculty and staff

Women with blood pressure levels within the range of clinically considered normal during pregnancy and women whose blood pressure does not drop during pregnancy are at a higher risk of developing hypertension five years after birth.
These women are not flagged as high risk by current medical guidelines – about 12% of the population surveyed. However, new findings from UB Research will help identify them for early interventions.
The findings were recently published in the Journal of the American College of Cardiology: Advances. The first author of this study is Zhongzheng (Jason) Niu, an assistant professor in the Department of Epidemiology and Environmental Health at UB's Faculty of Public Health and Health, and a Presidential Sustainability Solutions Fellow at the University of Southern California. Shohreh Farzan, an associate professor of population and public health sciences at the Keck School of Medicine at USC, is a senior author of the study.
This work was supported by the National Institutes of Health and the Environmental Protection Agency.
The researchers collected data on blood pressure and other health factors up to five years after birth from 854 pregnant women. Its longitudinal approach allowed us to map blood pressure trajectories in pregnant women and to find a link between specific blood pressure patterns and hypertension a few years later.
“Women's health can change dramatically between pregnancy and menopause, but that's a period that we barely know about,” says Niu. “Our research helps us understand the gap when it comes to hypertension.”
In most women in this study (80.2%), systolic blood pressure (higher number of blood pressure measurements) remained low during pregnancy. In 7.4% of women, blood pressure began to rise, dropping later in pregnancy, and then increased again.
The third group of women (12.4%) had slightly increased systolic blood pressure and remained healthy levels during pregnancy, but not lowered in the later stages of pregnancy. Compared to the first group, these women were sometimes at a 4.91-fold higher risk of hypertension in the five years after birth.
“This group of groups have had a higher risk of long-term hypertension due to blood pressure below the diagnostic threshold.
Findings suggest that tracking blood pressure patterns during pregnancy can help identify this unrecognized group and identify planned interventions that may prevent cardiovascular disease.
These findings occur when both the American Heart Association (AHA) and the US obstetrician and gynecologist are focusing on female heart health. After submitting results to the 2023 AHA Epi | Lifestyle Conference, NIU received the organization's Trudy Bush Fellowship for Cardiovascular Disease Research in Women's Health.
Simple changes in clinical practice can help identify and treat this high-risk group, Niu says. Clinicians can map blood pressure during pregnancy and follow up with women without dips in the middle of pregnancy, even if their readings remain within normal range. AHA, which updated its general population hypertension cutoff in 2017, may also consider adjusting blood pressure guidelines during pregnancy.
Additional research is needed to replicate the findings and learn more about women from both at-risk groups. NIU, Farzan and colleagues are also investigating whether environmental exposures containing air pollution, heavy metals, and polyfluoroalkyl substances (PFAs), also known as “Forever Chemicals,” are associated with changes in blood pressure patterns during and after pregnancy.
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