Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal mortality and can put both mother and baby at risk for problems during pregnancy. Women who had HDPs have postpartum risks of chronic hypertension up to ten times those observed among women with no history of HDPs. However, management of postpartum hypertension remains inconsistent among women who had HDPs. This study aimed to understand existing postpartum care patterns to help health care systems determine more effective follow-up methods and address persistent postpartum hypertension as early as possible.

The researchers in this study investigated whether patterns of antihypertensive medication use in the first two years after delivery differed from women with or without HPD. The study used data from a Danish register which included 784,782 women with at least 1 pregnancy lasting 20 or more weeks. Only the first pregnancy for these women who delivered between January 1995 to December 2018 was considered in the study.

The results found that 36,900 (4.7%) of the participants had an HDP. The percentage of women who initiated postpartum antihypertensive treatment was 1.8% among women who hadn’t had HDPs and 44.1% among women with severe preeclampsia. Most women who required postpartum antihypertensive medication began use within three months of delivery (severe preeclampsia, 87%; preeclampsia, 75%, gestational hypertension 75%). Women with gestational hypertension were the most likely to initiate mediation after more than one year postpartum, with 11% of these patients starting treatment after this period.

The study found that blood pressure medication use varied by HDP status, severity, and specific condition. Approximately a quarter of study participants began medication more than 3 months postpartum. Researchers suggest routine postpartum blood pressure monitoring to prevent diagnostic delays in the initiation of antihypertensive medication use to improve cardiovascular disease prevention among women.

Take Home: Early diagnosis and effective management of persistent postpartum hypertension is an effective strategy to reduce long-term cardiovascular disease among women with pregnancies complicated by HDPs. It is important to prioritize regular visits with your primary care provider or cardiologist to ensure the best outcomes.

To learn more about your long-term health and download our free “My Health Beyond Pregnancy” resource, visit https://www.preeclampsia.org/beyondpregnancy.

Link: https://pubmed.ncbi.nlm.nih.gov/39110457/ 

Citation: Lihme F, Basit S, Thilaganathan B, Boyd HA. Patterns of Antihypertensive Medication Use in the First 2 Years Postpartum. JAMA Netw Open. 2024 Aug 1;7(8):e2426394. doi: 10.1001/jamanetworkopen.2024.26394. PMID: 39110457; PMCID: PMC11307130.