Research progress of quercetin in cardiovascular disease

Blood Pressure Patterns During Pregnancy Predict Later Hypertension Risk, Study Finds

Women with blood-pressure levels in a range considered clinically normal during pregnancy, and who have no drop in blood pressure in the middle of pregnancy, face an increased risk of developing hypertension in the five years after giving birth.

These women — about 12% of the population studied — would not be flagged as high-risk by current medical guidelines. New findings from UB research, however, could help identify them for early intervention.

The findings were recently published in the Journal of the American College of Cardiology: Advances. The study's first author is Zhongzheng (Jason) Niu, assistant professor in the Department of Epidemiology and Environmental Health in UB's School of Public Health and Health Professions and a Presidential Sustainability Solutions Fellow at the University of Southern California. Shohreh Farzan, associate professor of population and public health sciences at the Keck School of Medicine of USC, is the study's senior author.

The work was supported by the National Institutes of Health and the Environmental Protection Agency.

Researchers collected data on blood pressure and other health factors from 854 women during pregnancy and up to five years postpartum. That longitudinal approach allowed them to map the trajectory of women's blood pressure throughout pregnancy, and to spot a link between specific blood pressure patterns and hypertension several years later.

"Women's health can change a lot between pregnancy and menopause, but it's a period we know very little about," Niu says. "Our study helps fill that gap in understanding when it comes to hypertension."

An unexpected risk

For most women in the study (80.2%), systolic blood pressure (the higher number in a blood pressure reading) remained low throughout pregnancy. In 7.4% of women, blood pressure started out high, dropped during the second trimester, then increased again.

A third group of women (12.4%) had slightly elevated systolic blood pressure that remained at a healthy level throughout pregnancy, but did not drop during the second trimester. Compared to the first group, these women faced a 4.91 times higher risk of hypertension in the five years after giving birth.

"This group of women would not be identified as having higher long-term hypertension risk by any of the current clinical criteria, since their blood pressure remained below diagnostic thresholds, and most did not have other traditional risk factors," says Farzan.

The findings suggest that tracking blood pressure patterns during pregnancy could help identify this underrecognized group and plan interventions that may prevent cardiovascular disease.

Understanding women's heart health

These findings come at a time when both the American Heart Association (AHA) and the American College of Obstetricians and Gynecologists are increasing their focus on women's heart health. After submitting the results to the AHA EPILifestyle meeting in 2023, 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 throughout pregnancy and follow up with women who lack a second-trimester dip, even if their readings stay within the normal range. The AHA, which updated hypertension cutoffs for the general population in 2017, may also consider adjusting its guidelines for blood pressure during pregnancy.

Additional studies are needed to replicate the findings and to learn more about women in both at-risk groups. Niu, Farzan and their colleagues are also exploring whether environmental exposures — including air pollution, heavy metals, and per- and polyfluoroalkyl substances (PFAS), also known as "forever chemicals" — are linked to changes in blood pressure patterns during and after pregnancy.

Pregnancy Complications Affect Future Heart Health

FRIDAY, April 18, 2025 (HealthDay News) -- Complications during pregnancy can mean a woman's future heart health is at risk, particularly if she is overweight or obese, a new study says.

Women who are carrying excess weight prior to pregnancy are more likely to develop complications like gestational diabetes and high blood pressure while expecting, researchers said.

These complications act as a natural "stress test" that provides a glimpse into a woman's future health and risks for chronic illness, researchers said.

The results "suggest that prioritizing weight management among those considering pregnancy may promote both maternal and future cardiovascular health," lead investigator Jaclyn Borrowman, a postdoctoral research fellow at Northwestern University, said in a news release.

For the study, researchers tracked nearly 4,300 women across nine countries, following them for 10 to 14 years after their pregnancy.

About 67% of the women had a normal body mass index (BMI), 22% were overweight and 11% were obese, researchers said. BMI, which stands for body mass index, is an estimate of body fat based on height and weight.

Results showed that women who developed gestational diabetes were more likely later in life to suffer from higher blood glucose levels and other warning signs of type 2 diabetes.

Likewise, those who developed high blood pressure during pregnancy were more likely to have high blood pressure in later life.

However, Borrowman noted that these pregnancy complications only contributed to women's future heart risk, and did not fully explain away the risk. Other factors are involved.

"Understanding the connection between adverse pregnancy outcomes and cardiovascular disease is important in the development of effective preventative strategies and determining the best timing for intervention to support long-term heart health," Borrowman said.

In an accompanying editorial, Dr. Garima Sharma said the study provides "insightful information" that could help doctors track women's heart risk factors following pregnancy.

"The results of the study underscore the value in addressing excess [fatty tissue] in the pre-pregnancy and postpartum period, particularly as there are options with emerging therapies such new anti-obesity medications," Sharma, director of cardio-obstetrics at Inova Health System in Virginia, said in a news release,

The new study appears in the journal JACC.

More information

The American Heart Association has more on pregnancy complications and heart health risk.

SOURCE: American College of Cardiology, news release, April 14, 2025

Women who've had pregnancy complications should take steps to protect their heart health, particularly if they carry excess weight.

Comparing Oral Antihypertensives For Hypertensive Disorders In Pregnancy

Photo Credit: SDI Productions

The following is a summary of "Oral antihypertensive treatment during pregnancy: a systematic review and network meta-analysis," published in the April 2025 issue of American Journal of Obstetrics & Gynecology by Hup et al. 

Researchers conducted a retrospective study to examine the effects of antenatal treatment with methyldopa, labetalol, or nifedipine on maternal, fetal, and neonatal morbidity and mortality in hypertensive disorders of pregnancy.  

They performed an electronic search on August 25, 2023, in PubMed/Medline, Embase, and CENTRAL. Randomized controlled trials (RCTs) reporting perinatal outcomes in hypertensive pregnancies treated with oral antihypertensive agents (methyldopa, labetalol, or nifedipine) or placebo/no treatment were identified. Quality assessment was performed using the Cochrane Risk-of-Bias tool for RCTs, and trustworthiness was assessed using the Trustworthiness in Randomised Controlled Trials Checklist. Data on predefined outcomes were extracted, and relative risks were calculated in network estimates when feasible.  

The results showed that 23 trials (3,989 women) were analyzed, with overall evidence quality ranging from low to moderate. Compared to placebo/no treatment, labetalol and methyldopa significantly lowered severe hypertension risk (8 studies), with relative risks of 0.20 (95% CI 0.09–0.48) and 0.44 (0.20–0.99), respectively. In the network meta-analysis, labetalol versus nifedipine was linked to a reduced risk of preeclampsia (relative risk 0.50 [0.28–0.87]; 15 studies) and preterm birth (relative risk 0.68 [0.52–0.90]; 14 studies). No significant differences were observed for other outcomes.  

Investigators concluded that head-to-head comparisons of currently available oral antihypertensive agents did not reveal significant differences in severe hypertension or most secondary outcomes, although a modest preference for labetalol over nifedipine was noted for preeclampsia and preterm birth. 

Source: ajog.Org/article/S0002-9378(25)00218-2/fulltext 

---