01 Feb Postpartum Screening Important For Women With Hypertension During Pregnancy
MEDICALRESEARCH.COM INTERVIEW WITH:
KRISTI REYNOLDS, PHD, MPH
KAISER PERMANENTE RESEARCH
RESEARCH & EVALUATION
PASADENA, CA 91101
Medical Research: What is the background for this study?
Dr. Reynolds: Hypertensive disorders during pregnancy are common, affecting up to 10 percent of all pregnant women, and include gestational hypertension, preeclampsia (which is a combination of high blood pressure and protein in the urine), and eclampsia, which includes seizures in women with severe preeclampsia. Research has shown that hypertensive disorders in pregnancy are associated with long-term cardiovascular disease risk, but little is known about the effect of these conditions in the early years after delivery.
As part of our study, we examined the electronic health records of 5,960 women who had prenatal care and delivered a baby at the Kaiser Permanente Southern California Bellflower Medical Center between 2005 and 2010. Women with high blood pressure before their pregnancy were excluded from the analysis.
Medical Research: What are the main findings?
Dr. Reynolds: We found that women who had a hypertensive disorder during pregnancy were 2.4 times more likely – and women with pre-eclampsia/eclampsia 2.5 times more likely – to develop pre-hypertension or hypertension in the year after delivery than those who maintained a normal blood pressure during their pregnancy, after controlling for differences between the groups.
In comparison to women with normal blood pressure during pregnancy, women with pregnancy-related hypertension tended to be slightly younger and overweight or obese before pregnancy. In addition, they were more likely to have had one or more children previously and to gain excess weight and develop gestational diabetes during their pregnancy.
Medical Research: What should clinicians and patients take away from your report?
Dr. Reynolds: The study highlights the importance of monitoring and controlling blood pressure not only during pregnancy, but after delivery as well. Women who develop hypertension, preeclampsia, or eclampsia in pregnancy should discuss monitoring their blood pressure after delivery with their physicians
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Reynolds: Further research is needed to determine whether early postpartum blood pressure screening and improved follow-up and treatment of women with pregnancy-related hypertensive disorders may prevent future cardiovascular disease.
Mary Helen Black, Hui Zhou, David A. Sacks, Sascha Dublin, Jean M. Lawrence, Teresa N. Harrison, Kristi Reynolds. Hypertensive disorders first identified in pregnancy increase risk for incident prehypertension and hypertension in the year after delivery. Journal of Hypertension, 2016; 1 DOI: 10.1097/HJH.0000000000000855
KRISTI REYNOLDS, PHD, MPH (2016). Postpartum Screening Important For Women With Hypertension During Pregnancy MedicalResearch.com