Management of arterial hypertension in women after delivery (a literature review)

Abstract

We present a literature review on short-/long-term management of women with postpartum hypertension (HTN). Future health risks for women with a history of hypertensive disorders of pregnancy (preeclampsia and gestational HTN) are listed. Nonpharmacological therapy and medications for cardiovascular risk management in women with adverse pregnancy outcomes are considered. Inter-pregnancy care details for women with HTN are given.Hypertension-related reasons to discontinue breastfeeding are listed. Medical, ethical and legal issues of a decision-making process in hypertension management during lactation are considered. Sources of reliable information on compatibility of medications and breastfeeding, as well as the information about the use of antihypertensive medications during lactation from LactMed database and package leaflets are given. Dyslipidaemia in women with postpartum HTN is considered and approaches to lipid-lowering medication during breastfeeding (statins, ezetimibe and PCSK9 inhibitors) are discussed. Both known (aspirin, calcium) and investigated (metformin, statins, hydroxychloroquine) prevention modalities in preeclampsia are presented. The implementation of multidisciplinary maternal health clinics for women with a history of HTN pregnancy is reported.