Increased CV Complications in Postpartum period Linked to Chronic Hypertension

A retrospective cohort study published in the Obstetrics and Gynecology Green Journal uncovered a previously underestimated risk for cardiovascular disease (CVD) in the postpartum period, the chronic hypertension which significantly heightens the risk of readmission for CVD complications in the year following childbirth.

This research was conducted using the Healthcare Cost and Utilization Project's Nationwide Readmission Database from 2010 to 2018 and involved patients aged 15 to 54 years. This study analyzed data from 27,395,346 delivery hospitalizations which resulted in singleton births. 2.0% individuals out of the 544,639 had chronic hypertension. Also, the rate of CVD hospitalization among the patients with chronic hypertension was 4.7 times higher when compared to the normotensive patients (645 vs. 136 per 100,000 delivery hospitalizations). Adjusted hazard ratios revealed a startling 4.11 times higher risk of CVD complications in those with chronic hypertension.

The heightened risk of CVD complications persisted for a whole year after delivery. Individuals with chronic hypertension were found to face a significantly increased risk even within the first month of postpartum. This highlights the critical need for postpartum monitoring and timely intervention.

These findings underline the urgent need to pay closer attention to individuals with chronic hypertension during and after pregnancy. The study emphasize the importance of implementing robust monitoring mechanisms and timely interventions that can aid in managing blood pressure and reduce related complications in the postpartum period.

This research highlights chronic hypertension in the absence of preeclampsia as a substantial risk factor for CVD in the postpartum. The study advocates for an update in postpartum care by urging the medical community to consider chronic hypertension as a major variable to assess and address cardiovascular risks in the postpartum period. 

Reference:

Rosenfeld, E. B., Brandt, J. S., Fields, J. C., Lee, R., Graham, H. L., Sharma, R., & Ananth, C. V. (2023). Chronic Hypertension and the Risk of Readmission for Postpartum Cardiovascular Complications. In Obstetrics & Gynecology (Vol. 142, Issue 6, pp. 1431–1439). Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/aog.0000000000005424