Studies have shown women with hypertensive disorders of pregnancy have increased risk of hypertension and cardiovascular disease later in life. In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) developed new hypertension guidelines defining Stage I hypertension as a blood pressure greater than or equal to 130/80. We sought to identify characteristics associated with Stage I hypertension in the 3-24 months postpartum period.
A retrospective, IRB approved cohort study on postpartum hypertension from deliveries from 07/09-07/16. Inclusion criteria were delivery at our institution, presence of a hypertensive disorder of pregnancy, and a documented blood pressure between 3-24 months postpartum. Exclusion criteria were chronic hypertension and discharge home on antihypertensive medication. Postpartum hypertension was defined by the 2017 ACC/AHA definition. Chi-square test was used for categorical variables. Student T-test was used for continuous variables.
444 women met inclusion and exclusion criteria. Of these women, 349 (79%) were identified as having hypertension 3-24 months postpartum. Women with persistent hypertension were more likely to receive antepartum antihypertensive therapy (P=.04), be older (P=.022), have a higher pre-pregnancy BMI (P=.002), and be multiparous (P=.017). There were no differences amongst other study variables.
Approximately 79% of women in our cohort remained hypertensive. Women that were persistently hypertensive were more likely to be older, have a higher pre-pregnancy BMI, be multiparous, and be treated antepartum with an antihypertensive agent. This large incidence of postpartum hypertension as well as identifying characteristics warrants further study, as identifying these women early may improve follow up and long-term outcomes.