TOPLINE:

Individuals with hypertensive disorders of pregnancy, whether diagnosed before, during, or after childbirth, had a higher risk of developing incident hypertension than those without hypertensive disorders of pregnancy.

METHODOLOGY:

• Researchers conducted a secondary analysis of data from a prospective observational cohort enrolling 4342 nulliparous individuals with singleton pregnancies (mean maternal age, 27.0 years) in their first trimester across eight clinical sites in the US, who also attended a 2- to 7-year follow-up.
• Hypertensive disorders of pregnancy included gestational hypertension, preeclampsia or eclampsia (with or without severe features), and hemolysis, elevated liver enzyme levels, and low platelet count syndrome.
• Timing of the onset of the hypertensive disorders was categorized as antepartum (before labor), intrapartum (at the start of labor or induction to delivery), or postpartum (after delivery to 6 weeks postpartum), with no hypertensive disorders of pregnancy as reference.
• The outcome was incident hypertension at the 2- to 7-year visit assessed by triplicate blood pressure (BP) measurements under a standardized protocol and classified per the 2017 American College of Cardiology/American Heart Association criteria for stage 1 or greater hypertension: mean systolic BP ≥ 130 mm Hg, mean diastolic BP ≥ 80 mm Hg, or use of antihypertensive medication.
• The association between the initial diagnosis of hypertensive disorders of pregnancy vs no diagnosis and incident hypertension at follow-up was evaluated.

TAKEAWAY:

• Hypertensive disorders of pregnancy occurred in 23.2% of participants, with 53.6% of them diagnosed antepartum, 42.4% diagnosed intrapartum, and 4.0% diagnosed postpartum. At follow-up, incident hypertension was noted in 37.6%, 26.0%, and 40.0% of individuals in the respective groups compared with 16.5% of those with no hypertensive disorders of pregnancy.
• A hypertensive disorder of pregnancy vs no diagnosis was associated with increased odds of incident hypertension regardless of the timing of onset: antepartum (adjusted odds ratio [aOR], 2.40; 95% CI, 1.95-2.95), intrapartum (aOR, 1.55; 95% CI, 1.21-1.97), or postpartum (aOR, 2.90; 95% CI, 1.49-5.64).
• Comparisons across onset timings showed antepartum vs intrapartum onset of the hypertensive disorder was associated with higher adjusted odds of incident hypertension (P < .01), with similar findings for postpartum vs intrapartum onset of the hypertensive disorders (P = .04).
• Findings were consistent for stage 2 hypertension (systolic BP ≥ 140 mm Hg, diastolic BP ≥ 90 mm Hg, or use of antihypertensive medication) as well as across types of hypertensive disorders — gestational hypertension or preeclampsia.

IN PRACTICE:

“Our analysis suggests that new-onset HDP [hypertensive disorders of pregnancy] regardless of when it develops (during pregnancy, labor, or postpartum) is associated with incident hypertension and highlights the importance of appropriate patient counseling and care after pregnancy,” the authors wrote.

SOURCE:

The study was led by Alisse Hauspurg, MD, MS, of the Warren Alpert Medical School at Brown University in Providence, Rhode Island. It was published online on February 12, 2026, in Obstetrics & Gynecology.

LIMITATIONS:

The study focused only on hypertensive disorders during first pregnancy. Diagnosis of incident hypertension relied on just one research visit without home BP data.

DISCLOSURES:

The study received support from National Institutes of Health programs, including Building Interdisciplinary Research Careers in Women’s Health to one author, along with funding from National Heart, Lung, and Blood Institute and the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Additional support was received from the National Institutes of Health Office of Research on Women’s Health, the Office of Behavioral and Social Sciences Research, and the National Center for Advancing Translational Sciences, the Barbra Streisand Women’s Cardiovascular Research and Education Program, and the Erika J. Glazer Women’s Heart Research Initiative, Cedars-Sinai Medical Center. No relevant conflicts of interest were reported by the authors.

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