Blood Pressure Monitoring and Knowledge in the First Year after a Hypertensive Disorder of Pregnancy.

Abstract

Introduction: In the first year postpartum, hypertension is a leading cause of morbidity and mortality, particularly for those with hypertensive disorders of pregnancy (HDPs). Given that timely recognition of hypertension is key to reducing short- and long-term cardiovascular risk, we assessed knowledge of when to seek medical attention for blood pressure (BP) elevations and rates of BP measurement in the first year postpartum. Methods: This was a secondary analysis of a cohort of 405 primiparas who enrolled in a randomized trial during pregnancy. We calculated the proportion who stated they would contact a clinician for a systolic BP above 140 and a diastolic BP above 90 at 3 months postpartum, and the frequency and location of BP checks reported from 2 to 12 months postpartum by HDP status. Results: HDPs were reported by 16% of participants. Mean age was 32 ± 5 years; 40% identified as non-White, and 25% had public insurance. At 3 months postpartum, 44.6% with HDPs and 23.5% without identified a systolic BP of 140 as the threshold above which to contact a clinician (p < 0.01); 52.4% with HDPs and 28.5% without identified a diastolic BP threshold of 90 (p < 0.01). From 3 to 12 months postpartum, people with HDPs were more likely to report a BP check (83.1% versus 59.4%, p < 0.01) and home BP monitoring (41.6% versus9.7%, p < 0.01). Home monitoring was not associated with awareness of when to seek help for hypertension among those with HDPs. Conclusions: Efforts are needed to improve awareness of when to seek medical attention for postpartum hypertension.