BU professor to examine the role of postpartum hypertension on recurrent HDP risk

Dr. Samantha Parker Kelleher of the Boston University School of Public Health will lead a study to determine how high blood pressure during the postpartum period affects the risk of recurrent hypertensive disorders of pregnancy (HDP). Funded by a $3.2 million, five-year grant from the National Heart, Lung, and Blood Institute, the project aims to identify interventions before a subsequent pregnancy begins to reduce HDP rates, which range from 15% to 45% among mothers in the U.S.

Why is postpartum hypertension a significant health risk?

Hypertensive disorders of pregnancy, including preeclampsia and gestational hypertension, affect up to 10% of U.S. pregnancies. According to the study’s framework, these conditions are strongly linked to cardiovascular disease and often recur. This puts mothers with more than one child at a higher risk for stroke, chronic hypertension, and heart disease, affecting at least 70% of this group.

Up to half of women who experience HDP also develop hypertension during the first six weeks following birth. Dr. Parker Kelleher describes this postpartum window as a unique and underutilized time to assess risk factors and solutions for recurrent HDP.

Did You Know? Black and Hispanic pregnant people are disproportionately affected by hypertensive disorders of pregnancy, and approximately 30% of patients at Boston Medical Center experience these disorders before or during pregnancy.

How will the research track and prevent recurrent HDP?

Researchers from the BU School of Public Health and Boston Medical Center (BMC) will analyze health data from approximately 3,500 BMC patients between 2016 and 2025. The team will specifically focus on patients who have had at least two children and experienced HDP.

The study utilizes a home blood pressure monitoring program launched in 2020. Patients use cloud-connected cuffs that transfer readings to a web portal via cellular technology. Dr. Erica Holland, an obstetrician-gynecologist at BMC, states that this allows clinicians to manage elevated blood pressure remotely and facilitate urgent evaluations to prevent seizures, stroke, and hospital readmissions.

Expert Insight: The shift toward pre-pregnancy intervention is the critical stake here. By moving the clinical focus from early prenatal care to the postpartum window, researchers may bypass common barriers to care that often prevent mothers from receiving timely interventions once they are already pregnant.

What role do breastfeeding and medication thresholds play?

The project aims to refine guidelines for prescribing antihypertensive medications postpartum. Researchers will examine the impact of lowering the medication threshold from 150/100 mmHg to the current definition of 140/90 mmHg.

Dr Karla Neves – Hypertension Research

Additionally, the team will use electronic health records to study how breastfeeding duration affects recurrent HDP. Dr. Katherine Standish, a family medicine physician at BMC, notes that improved cardiovascular indicators can appear as soon as one month after breastfeeding begins, with greater risk reduction occurring the longer a mother breastfeeds.

What may happen next as the study progresses?

The data collected could lead to new clinical guidelines regarding the timing and threshold for postpartum medication. Researchers may identify specific actions mothers can take, such as primary care engagement or weight change, to mitigate the recurrence of HDP.

The findings may also help clinicians identify which mothers would benefit most from breastfeeding support to improve their own cardiovascular health and the health of their babies.

Frequently Asked Questions

What are hypertensive disorders of pregnancy (HDP)?
HDP includes conditions such as preeclampsia, as well as chronic and gestational hypertension.

What is the current evidence-based treatment for recurrent HDP?
According to the source, the only current evidence-based preventive treatment is low-dose aspirin, which must be prescribed early in a subsequent pregnancy to be effective.

Who is conducting this research?
The study is led by Dr. Samantha Parker Kelleher and Dr. Christina Yarrington, with additional research from Dr. Erica Holland, Dr. Katherine Standish, Dr. Sarah Gordon, and Dr. Kerrie Nelson.

Do you believe remote health monitoring technology will become the standard for postpartum care in the U.S.?