Protein Screening Does Not Improve Risk Prediction for Hypertension

Results from a large NIH-supported study show that protein analyses taken during the first trimester of pregnancy did not improve predictions for identifying people at risk for experiencing conditions related to having high blood pressure, hypertension, during pregnancy. Since there is an urgent need to better predict people at risk for hypertensive disorders of pregnancy, researchers have been studying if proteins taken from blood or urine samples could provide this insight.

For this study, researchers analyzed 6,481 proteins from 1,850 participants who had a first pregnancy between 2010 and 2013. Participants provided a blood sample during the study enrollment and had study check-ins during their second and third trimesters, after delivery and two to seven years after their pregnancy.

The protein analysis was used in different modeling equations to assess if proteins or their combinations with clinical data, such as maternal age and cardiovascular disease risks, during early pregnancy could provide clues for the 753 participants who experienced a hypertensive disorder of pregnancy. The conditions assessed included gestational hypertension, marked by high blood pressure that typically develops after 20 weeks of pregnancy, and preeclampsia, a significant rise in blood pressure after 20 weeks of pregnancy that can damage organs and is marked by elevated levels of protein in the urine.

The prediction models, which included three different types of assessments, did not significantly improve risk predictions for these events. These criteria currently include risk factors such as having obesity, diabetes, high blood pressure or a baby later in life.

Hypertensive disorders of pregnancy affect about 10-15% of people and are associated with increased risks for having a pregnancy complication, heart attack, stroke and in severe cases death.