Factors Associated With Hypertension 2-5 Years Postpartum in Women With Hypertensive Diseases of Pregnancy [17M]

Abstract

INTRODUCTION: To identify factors associated with hypertension 2-5 years following delivery complicated by a hypertensive disease of pregnancy. METHODS: We performed a single-center, retrospective cohort study of women with a hypertensive disease of pregnancy who delivered between 7/2009-1/2014. Women with hypertension predating the incident pregnancy and those discharged on anti-hypertensive medications were excluded. Hypertension was defined as SBP greater than 140 mmHg, and/or DBP greater than 90 mmHg, and/or office visit for management of anti-hypertensive medications. A secondary analysis using SBP greater than 130 mmHg and/or DBP greater than 80 mmHg was also performed. Data was collected through review of electronic medical record. Institutional IRB approval was obtained. RESULTS: 284 women were eligible for analysis. Of these women, 123 (43%) were considered hypertensive at 2-5 years following delivery. They were more likely to be older (P=.001), have a higher pre-pregnancy BMI (p<.001), be of higher parity (p<.001), undergo cesarean section (P=.002), and to have higher blood pressure immediately postpartum (P=.002, P=.027). When the definition of hypertension outlined by 2017 AHA recommendations (greater than 130/80) was used, 65% of the women were found to have hypertension and the same associations existed. CONCLUSION: A large proportion of women with a hypertensive disease of pregnancy had evidence of hypertension at 2-5 years postpartum. This proportion was even greater when the 2017 AHA definition was applied. Some factors associated with developing hypertension were identified in this study and could be considered while addressing importance of long term follow up for women given the magnitude of effect.