TOPLINE:

Women with a higher genetic risk for high systolic blood pressure (SBP) were more likely to develop hypertension within a few years after their first pregnancy, but high BMI and a history of hypertensive disorders of pregnancy were stronger contributors to risk.

METHODOLOGY:

• Researchers conducted a follow-up study (nuMoM2b Heart Health Study) of a prospective cohort to determine whether a high genetic risk for SBP was associated with the risk for new-onset hypertension within 2-7 years after a first pregnancy.
• They analyzed data from 2852 women in their first pregnancy without preexisting hypertension across eight US centers between 2010 and 2013; the mean age was 30.8 years.
• The genetic risk for SBP was calculated using a genome-wide SBP polygenic score adjusted for genetic ancestry, and women were classified as having low (bottom 20%), intermediate (middle 60%), or high (top 20%) risk.
• Hypertensive disorders of pregnancy were identified from medical records and by applying standard definitions for gestational hypertension (BP ≥ 140/90 mm Hg after 20 weeks) and preeclampsia (with organ dysfunction).
• The primary endpoint was the development of stage I or higher hypertension, marked by BP ≥ 130/80 mm Hg or the use of antihypertensive medication. The mean follow-up duration was 3.2 years after delivery.

TAKEAWAY:

• Overall, 17.8% of women developed stage I or higher hypertension during the follow-up; 12.4% experienced hypertensive disorders of pregnancy during their first pregnancy.
• Women with high genetic risk for SBP had 50% higher odds of developing postpartum hypertension than those with low genetic risk for SBP after adjustment (P = .01).
• Each 1-SD increase in genetic risk score was associated with 25% increased odds of hypertension after adjustment among women without prior hypertensive disorders of pregnancy (P < .001); however, this association was not observed among those with a prior history of such disorders.
• Having a BMI ≥ 25 at postpartum follow-up accounted for 41.5% of the risk for new-onset hypertension, a history of hypertensive disorders of pregnancy accounted for 10.8% of the risk, and high genetic risk accounted for 4.7% of the risk.

IN PRACTICE:

“These findings highlight pregnancy and the postpartum period as an opportunity to assess and optimize cardiometabolic health toward long-term prevention of CVD [cardiovascular disease], including in those without HDP [hypertensive disorders of pregnancy],” the researchers wrote.

SOURCE:

The study was led by Jan Hemeryck, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts. It was published online on April 1, 2026, in JAMA Cardiology.

LIMITATIONS:

The inclusion of only first-time pregnant women may have limited the generalizability of the findings. Assuming uniform effects of genetic risk, prior hypertensive disorders of pregnancy, and postpartum BMI may have oversimplified the risk for hypertension. Additionally, the modest sample size of participants with prior hypertensive disorders of pregnancy may have limited statistical power to detect a significant association between the genetic risk for SBP and hypertension. 

DISCLOSURES:

The nuMoM2b Heart Health Study received funding from multiple sources such as the National Heart, Lung, and Blood Institute; the Eunice Kennedy Shriver National Institute of Child Health and Human Development; and the National Center for Advancing Translational Sciences. Additional support was provided by research programs and federal grants for women’s health and a university‐based genomics initiative. Some authors disclosed receiving research grants from public and private funders, as well as consulting and advisory fees from industry. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.