Hypertension During Pregnancy:
Impacts on Subsequent Cardiovascular Disease
by Micaela Harris-Kim
February 28, 2025
Preeclampsia and gestational hypertension are conditions in which pregnant women develop new-onset high blood pressure. These adverse pregnancy outcomes are associated with a significantly greater risks risk of cardiovascular disease later in life and appear to be a sex-specific cardiac risk factor. However, the pathophysiological mechanisms that might link events during pregnancy with long-term cardiovascular effects are still largely unknown.
A team of researchers at Stanford University, led by Mark Hlatky, MD, recently conducted a study called Effect of Preeclampsia on Cardiovascular Health (EPOCH) to explore the biological pathways that might link hypertensive disorders during pregnancy with cardiac events later in life. The outcomes of their study were recently published in the journal Hypertension.
The researchers looked at three different stages in the life course: during pregnancy, immediately after pregnancy (within a few weeks to months postpartum), and then two or more years after delivery. The investigators assayed levels of 7288 different proteins in the blood across these three time points to identify differences related to hypertensive disorders of pregnancy.
By surveying protein levels during pregnancy and several times postpartum, the researchers were able to identify several biological pathways that were altered by a hypertensive pregnancy.
They found that during a hypertensive pregnancy, most proteins tested were altered, but most differences resolved postpartum. However, a number of proteins were still different several months after delivery, and, more importantly, the pattern of changes in protein levels identified a few months postpartum persisted for several years after delivery.
These persistent differences suggests that hypertensive disorders of pregnancy might lead to long-term abnormalities that, in turn, could increase the risk of late life cardiovascular disease. The effects of pregnancy on women’s cardiovascular health are an important avenue of investigation and may suggest sex-specific approaches to disease prevention.
Additional Stanford Cardiovascular Institute investigators who contributed to this study include Chi-Hung Shu, David Stevenson, Gary Shaw, Marcia Stefanick, Xi Plummer, Oshra Sedan, Ronald Wong, Nima Aghaeepour, and Virginia Winn.
Dr. Mark Hlatky