Genetic Risk Scores and Postpartum Hypertension: Integrating Polygenic Insight with Clinical Risk Stratification

Highlights

• Systolic blood pressure (SBP) polygenic risk scores (PGS) are independently associated with new-onset hypertension 2 to 7 years post-delivery.
• The predictive value of genetic risk is most pronounced in women without a history of hypertensive disorders of pregnancy (HDP).
• Despite the significance of genetics, clinical factors—specifically elevated body mass index (BMI) and a history of HDP—account for a substantially higher proportion of population attributable risk.
• Persistence of specific proteomic signatures in complement and coagulation pathways provides a potential mechanistic bridge between pregnancy complications and long-term vascular disease.

Background