658 Factors associated with persistent hypertension at 1-year postpartum in individuals with gestational hypertension or preeclampsia

Abstract

To determine which factors are associated with persistent hypertension at 1-year postpartum (using the 2017 American College of Cardiology/American Heart Association [ACC/AHA] guidelines) in patients with a recent diagnosis of gestational hypertension or preeclampsia A retrospective case-control study of postpartum patients with a diagnosis of gestational hypertension or preeclampsia at their recent pregnancy (2014-2018) was performed. Patients that presented for a 1-year annual exam and blood pressure check were included in the analysis. Using univariable and multivariable analysis, demographic, clinical and labor characteristics were compared between patients who had persistent hypertension 1-year postpartum, defined as ≥130 systolic or ≥80 diastolic, and those with normal blood pressures. Of the 421 patients included in this analysis, 189 (44.9%) had persistent hypertension at 1-year postpartum. In univariable analysis, patients who were older, multiparous, had mild-range BPs prior to discharge, discharged home after delivery on antihypertensive medications, and patients with elevated blood pressures at 6-week postpartum visit, were more likely to have persistent hypertension at 1-year postpartum (Table 1). In multivariable logistic regression, nulliparity (aOR 0.57, 95% CI 0.35-0.92), mild range BPs on day of discharge after delivery (aOR 1.74, 95% CI 1.06-2.83), and elevated blood pressures at the 6-week postpartum visit (aOR 2.35, 95% CI 1.49-3.70) remained to be associated with persistent hypertension 1-year postpartum (Table 2). In this cohort, a high percentage of patients with a diagnosis of gestational hypertension or preeclampsia in their recent pregnancy had persistent hypertension at 1-year postpartum, using the 2017 ACC/AHA hypertension definition. Specific factors associated with persistent hypertension 1-year postpartum were nulliparity, elevated blood pressures prior to hospital discharge after delivery, and persistent hypertension at 6-week postpartum visit.View Large Image Figure ViewerDownload Hi-res image Download (PPT)