Early Pregnancy Blood Pressure Trajectories and Hypertension Years After Pregnancy | Hypertension
BACKGROUND: Hypertensive disorders of pregnancy (HDP) increase cardiovascular disease risk. Blood pressure (BP) trajectories ≤20 weeks’ gestation predict HDP outcomes. We hypothesized that early-pregnancy BP patterns stratify risk of developing hypertension years after pregnancy. METHODS: This prospective cohort of 174 774 women without prior hypertension, kidney, liver, or heart disease, or history of preeclampsia entered prenatal care ≤14 weeks and delivered a stillborn or live singleton birth at Kaiser Permanente Northern California hospitals (2009–2019). Electronic health records provided data, including HDP for each birth, longitudinal outpatient clinical BP measurements, International Classification of Diseases codes, and medication use to identify new-onset hypertension from 2 months through 14 years post-delivery (2009–2023). Latent class trajectory modeling identified 6 BP trajectory (BPT) groups capturing both BP levels and slopes from 0 to 20 weeks’ gestation. Multivariable
