Incidence and Risk Factors of De Novo Postpartum Hypertension: Understanding Links to Long-Term Cardiovascular Risk

Incidence and Risk Factors of De Novo Postpartum Hypertension: Understanding Links to Long-Term Cardiovascular RiskJACC Adv. 2025 Jun, 4 (6_Part_1) 101756 AbstractBackgroundIndividuals developing hypertensive disorders of pregnancy face a 2- to 5-fold risk of long-term cardiovascular disease. Limited data exist on de novo postpartum hypertension (dnPPHTN), where those normotensive during pregnancy develop hypertension immediately postpartum.Under-recognition of de novo postpartum hypertension can lead to severe morbidity due to delayed or absent treatment and missed opportunities for mitigating long-term cardiovascular disease risk. ObjectivesThe aim of the study was to estimate theincidence of de novo postpartum hypertension and identify demographic and clinical risk factors for its development. MethodsThis retrospective cohort study analyzed 506 postpartum individuals delivering at a tertiary care institution over 1month. Participants were classified as: 1) normotensive; or 2) de novo postpartum hypertension, defined as systolic blood pressure (BP) ≥140 mm Hg and/or diastolic BP ≥90 mm Hg on at least 2 occasions up to 6 weeks postpartumafter a normotensive pregnancy. We excluded those with prepregnancy or antepartum hypertensive disorders. Demographic and clinical characteristics were compared using adjusted logistic regression models. ResultsOf 389 included participants, 35 (9.0%) developed de novo postpartum hypertension. Of these, 5.7% had pregestationaldiabetes compared to 0.6% of normotensive individuals (P = 0.042; adjusted OR: 11.3; 95% CI: 1.8-73.1). Early prenatal diastolic BP was higher in the de novo postpartum hypertension group (72.2 vs 68.4 mm Hg, P =0.008), though this difference did not persist after adjustment. Medication-dependent gestational diabetes mellitus (ie, A2GDM) was associated with de novo postpartum hypertension (adjusted OR: 6.1; 95% CI: 1.2-30.1). ConclusionsPregestational diabetes and Medication-dependentgestational diabetes mellitus are associated with de novo postpartum hypertension. Closer follow-up for BP monitoring postpartum and more urgent transitions of care for ongoing medical management may reduce long-termcardiovascular risk.Disclaimer:Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STARUPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.