Prehypertension in Pregnancy Linked to Postpartum Metabolic Syndrome Interview with:

Jian-Min Niu Department of Obstetrics Guangdong Women and Children Hospita Guangzhou , China

Dr. Jian Min Niu

Dr. Jian-Min Niu
Department of Obstetrics
Guangdong Women and Children Hospita
Guangzhou , China What is the background for this study?

Response: Physiological alteration leads to the question of whether the criteria for the diagnosis of gestational hypertension are suitable because the current criteria (systolic BP [SBP] ≥140 mm Hg and diastolic BP [DBP] ≥90 mm Hg) are derived from the non-pregnant population. The optimal blood pressure levels in pregnant women remain an open question. Recent studies have demonstrated associations between prehypertension before pregnancy and hypertensive disorders during pregnancy and gestational diabetes mellitus. To our knowledge, the association between prehypertension during pregnancy and postpartum cardiovascular risk has not been addressed. What are the main findings?


● In normotensive pregnant women, exposure to prehypertension (refers to blood pressure [BP] 120-139/80-89 mmHg) identified by diastolic BP trajectories throughout pregnancy, is associated with increased risk of developing postpartum metabolic syndrome.

● Compared with single measurement, diastolic blood pressure trajectories, which utilize multiple BP readings across the pregnancy course, provide additional information for future cardiovascular risk stratification.

●The blood pressure level-based stratification of cardiovascular risk management has been widely used in non-pregnant population. Our finding that blood pressure-stratification in “normotensive” pregnancy facilities the identification of high risk women for postpartum cardiometabolic risk, for the first time, raises the possibility that a more precise stratification of previously-regarded “safe range” of BP could be applied to pregnant population, which would in turn benefit both the mothers and infants. What should readers take away from your report?


• The exposure to prehypertension during pregnancy, as identified by diastolic blood pressure (BP) trajectories using multiple diastolic BP measurements, is an independent risk factor for developing postpartum metabolic syndrome.
• The incorporation of diastolic blood pressure trajectories with the levels of glucose and triglycerides at term provides a novel prediction model for postpartum metabolic syndrome. What recommendations do you have for future research as a result of this study?

Response: Our data highlight the need for the reevaluation of the pregnancy-specific blood pressure range using multiple blood pressure measurements for postpartum cardiovascular risk stratification. Is there anything else you would like to add?

Response: Blood pressure measurements are already done as matter of routine and cost-effective checkups during pregnancy, so our findings underscore this tool’s potential to gauge a woman’s post-partum cardiovascular risk. Early identification of metabolic risk factors and implementation of lifestyle modifications may help delay the onset of cardiovascular disease that would present 20 to 30 years after delivery. Thank you for your contribution to the community.


Prehypertension During Normotensive Pregnancy and Postpartum Clustering of Cardiometabolic Risk Factors: A Prospective Cohort Study

Qiong Lei, Xin Zhou, Yu-Heng Zhou, Cai-Yuan Mai, Ming-Min Hou, Li-Juan Lv, Dong-Mei Duan, Ji-Ying Wen, Xiao-Hong Lin, Peizhong P. Wang,Xuefeng B. Ling, Yu-Ming Li, and Jian-Min Niu

Hypertension. 2016;HYPERTENSIONAHA.116.07261published online before print June 27 2016, doi:10.1161/HYPERTENSIONAHA.116.07261

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on June 28, 2016 by Marie Benz MD FAAD