Blood Pressure Genetic Risk and Incident Hypertension at 2 to 7 Years Post Partum.

Area of Science:

• Cardiovascular Health
• Genetics
• Reproductive Medicine

Background:

• Hypertensive disorders of pregnancy (HDP), including preeclampsia and gestational hypertension, are linked to earlier onset of chronic hypertension.
• The role of genetic predisposition for high systolic blood pressure (SBP) in stratifying postpartum hypertension risk remains unclear.

Purpose of the Study:

• To investigate the association between genetic risk for high SBP and new-onset hypertension 2 to 7 years after delivery.
• To determine if genetic risk for high SBP independently predicts postpartum hypertension, beyond clinical factors and HDP history.

Main Methods:

• A cohort study involving genotyped participants from the nuMoM2b Heart Health Study was conducted across 8 US clinical sites.
• Systolic blood pressure (SBP) genetic risk was assessed using a genome-wide polygenic score, categorized as low, intermediate, or high.
• Logistic regression was used to analyze the association between SBP genetic risk and incident hypertension, adjusting for covariates. Population attributable risk was also calculated.

Main Results:

• Among 2852 women, 17.8% developed hypertension 2 to 7 years postpartum.
• Higher SBP genetic risk was independently associated with increased odds of developing hypertension (aOR, 1.50).
• This association was significant in women without prior HDP but not in those with HDP history. Elevated BMI demonstrated the highest population attributable risk for hypertension.

Conclusions:

• Increased genetic risk for high SBP is an independent predictor of new-onset hypertension years after pregnancy.
• Hypertensive disorders of pregnancy history and elevated postpartum BMI are more significant contributors to hypertension risk than SBP genetic risk.
• These findings highlight the complex interplay of genetic and clinical factors in postpartum cardiovascular health.