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Chronic Hypertension in Pregnancy: A Lens Into Cardiovascular Disease Risk and Prevention

HYPERTENSION (2023)

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Maternity care through the eyes of Southern European immigrant parents in Norway

Raquel Herrero-Arias et al.

Summary: Immigrant parents in Norway have experiences with reproductive health services that are influenced by coverage and organization, relationships with healthcare providers, and cultural influences on pregnancy and childbirth. They perceive a less interventionist approach towards pregnancy and childbirth in the host country's maternity care practices.

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Summary: This article introduces the latest statistics on heart disease, stroke, and cardiovascular risk factors published by the American Heart Association in conjunction with the National Institutes of Health. The Statistical Update includes data on a range of clinical heart and circulatory disease conditions and their associated outcomes. It serves as a critical resource for the general public, policymakers, healthcare professionals, researchers, and others seeking the best available data.

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Summary: Racism can manifest in both conscious and unconscious ways, and it can be seen as both a systemic and structural issue. Systemic and structural racism is deeply embedded within systems, laws, policies, and practices that perpetuate unfair treatment and oppression of people of color, leading to negative health consequences. Addressing these forms of racism requires coordinated efforts across multiple sectors and locations, with the crucial first step being the recognition of their existence.

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Intergenerational cardiovascular disease risks among Hispanics living in the United States

Marissa A. Kobayashi et al.

Summary: The study found significant associations between parental obesity and high blood pressure with corresponding indicators in Hispanic families, highlighting the importance of family interventions.

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Interventions to Mitigate Risk of Cardiovascular Disease After Adverse Pregnancy Outcomes A Review

Amanda R. Jowell et al.

Summary: Evidences suggest that adverse pregnancy outcomes are associated with increased risk of cardiometabolic and cardiovascular disease later in life, presenting an opportunity for intervention. Postpartum interventions targeting transitional clinics, lifestyle changes, pharmacotherapy, and education for women with a history of APOs show promise in improving maternal cardiometabolic health. Further research is needed on improving postpartum follow-up, increasing accessibility to interventions, raising awareness of sex-specific CVD risk factors, and developing evidence-based precision prevention strategies.

JAMA CARDIOLOGY (2022)

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Prevalence, Treatment, and Control of Hypertension Among US Women of Reproductive Age by Race/Hispanic Origin

Nicole D. Ford et al.

Summary: This study examines the prevalence, pharmacologic treatment, and control of hypertension among US nonpregnant women of reproductive age by race/Hispanic origin, aiming to identify potential gaps in care.

AMERICAN JOURNAL OF HYPERTENSION (2022)

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Summary: This study examined qualitative literature on the barriers to high-quality prenatal and postpartum care for low-income women. The findings showed that structural barriers, such as delays in accessing Medicaid coverage and challenges in finding providers who accept Medicaid, were the most frequently mentioned. Individual factors, such as lack of awareness and indifference towards pregnancy, also hindered timely use of care. Experiences of dismissal, discrimination, and disrespect based on race, insurance status, age, substance use, and language were common among those who accessed care. Medicaid policy changes may help address these barriers.

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Treatment for Mild Chronic Hypertension during Pregnancy

A. T. Tita et al.

Summary: In pregnant women with mild chronic hypertension, a strategy of targeting a blood pressure of less than 140/90 mm Hg was associated with better pregnancy outcomes compared to a strategy of reserving treatment only for severe hypertension, without increasing the risk of small-for-gestational-age birth weight.

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Clinician Knowledge and Practices Related to a Patient History of Hypertensive Disorders of Pregnancy

Nicole D. Ford et al.

Summary: This study described the screening practices, knowledge, barriers, and facilitators among clinicians for prior hypertensive disorders of pregnancy. Findings showed that while the majority of clinicians screened for these disorders, only one out of four correctly identified all associated cardiovascular risks.

OBSTETRICS AND GYNECOLOGY (2022)

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Article Obstetrics & Gynecology

Postpartum ambulatory and home blood pressure monitoring in women with history of preeclampsia: Diagnostic agreement and detection of masked hypertension

Virginia R. Nuckols et al.

Summary: This study found that home blood pressure monitoring (HBPM) may be a useful alternative to 24-hour ambulatory blood pressure monitoring (ABPM) for screening and managing postpartum hypertension. Women with a history of preeclampsia were at a higher risk for chronic hypertension after pregnancy, but the prevalence of masked postpartum hypertension did not differ significantly. HBPM showed good agreement with ABPM and could detect a certain percentage of masked postpartum hypertension cases.

PREGNANCY HYPERTENSION-AN INTERNATIONAL JOURNAL OF WOMENS CARDIOVASCULAR HEALTH (2022)

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Jena Wallander Gemkow et al.

Summary: This study found that postpartum patients at federally qualified health centers transitioned to primary care at low rates and insurance loss was identified as a significant barrier to care. Strategies to increase continuity, such as improving insurance access, should be studied further.

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Harmonization of the American College of Cardiology/American Heart Association and European Society of Cardiology/European Society of Hypertension Blood Pressure/Hypertension Guidelines: Comparisons, Reflections, and Recommendations

Paul K. Whelton et al.

Summary: The guidelines for the management of high blood pressure/hypertension by the American College of Cardiology/American Heart Association and the European Society of Cardiology/European Society of Hypertension are influential and show substantial concordance in their recommendations. The most notable difference is the blood pressure cut points recommended for diagnosis. Further harmonization of future guidelines could lead to improved prevention, awareness, treatment, and control of hypertension worldwide.

CIRCULATION (2022)

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Article Health Care Sciences & Services

Association of Health Insurance, Geography, and Race and Ethnicity With Disparities in Receipt of Recommended Postpartum Care in the US

Julia D. Interrante et al.

Summary: This study examines the differences in receipt and content of recommended postpartum care across health insurance type, rural or urban residency, and race and ethnicity in the US. The findings suggest extensive inequities in postpartum care content, especially for patients with multiple intersecting disadvantaged identities.

JAMA HEALTH FORUM (2022)

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A national cohort study and confidential enquiry to investigate ethnic disparities in maternal mortality

Marian Knight et al.

Summary: This research reveals the existence of multiple structural and other biases in maternity care in the UK. Some ethnic minority women experience lack of nuanced care, microaggressions, and clinical, social, and cultural complexity during the care process. Further study on the impact of microaggressions is needed.

ECLINICALMEDICINE (2022)

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ACC-AHA Diagnostic Criteria for Hypertension in Pregnancy Identifies Patients at Intermediate Risk of Adverse Outcomes

Kristin C. Darwin et al.

Summary: The study compared maternal and neonatal outcomes among normotensive, Stage I ACC-AHA hypertensive, and ACOG hypertensive patients. Patients with Stage I ACC-AHA hypertension in the first trimester had higher rates of preeclampsia, preterm birth, and SGA neonates compared with normotensive women. Adverse outcomes were numerically lower in the ACC-AHA group compared with the ACOG group, with statistical significance for preterm birth.

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Long-term cumulative blood pressure in young adults and incident heart failure, coronary heart disease, stroke, and cardiovascular disease: The CARDIA study

Chike C. Nwabuo et al.

Summary: The study found that cumulative blood pressure in young adults is associated with the risk of heart failure, coronary heart disease, stroke, and cardiovascular diseases. Cumulative blood pressure provides incremental prognostic value and improves risk reclassification for cardiovascular diseases when compared to single blood pressure assessments or changes in blood pressure.

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Racial and ethnic disparities in multimorbidity in non-pregnant women of reproductive age in Lambeth, UK: a data linkage study

Raquel Catalao et al.

LANCET (2021)

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Orna Reges et al.

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HYPERTENSION (2021)

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Article Medicine, General & Internal

Associations of Maternal Cardiovascular Health in Pregnancy With Offspring Cardiovascular Health in Early Adolescence

Amanda M. Perak et al.

Summary: Maternal cardiovascular health during pregnancy is significantly associated with offspring cardiovascular health during early adolescence, indicating a potential lifelong impact of maternal health status on offspring. This multinational cohort study reveals that poorer maternal cardiovascular health is correlated with higher risks of poorer cardiovascular health in offspring during early adolescence.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2021)

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Article Obstetrics & Gynecology

Bridging the postpartum gap: best practices for training of obstetrical patient navigators

Lynn M. Yee et al.

Summary: The postpartum period is a critical time for improving maternal health, but inadequate postpartum care, especially for individuals facing social and structural barriers, is common in the United States. Patient navigation is a patient-centered intervention that can help eliminate these barriers and promote comprehensive and timely access to health services.

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY (2021)

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Review Nutrition & Dietetics

Preconceptional maternal weight loss and hypertensive disorders in pregnancy: a systematic review and meta-analysis

Nicole Schenkelaars et al.

Summary: Preconceptional weight loss through lifestyle intervention or bariatric surgery is effective in reducing the risk of HDP, PIH, and PE in overweight and obese women, highlighting the importance of weight optimization for those with a desire to conceive. Further research is needed to examine both short-term and long-term beneficial and harmful effects of these interventions on maternal and offspring health.

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Article Medicine, General & Internal

Prevalence of Hypertension Among Pregnant Women When Using the 2017 American College of Cardiology/American Heart Association Blood Pressure Guidelines and Association With Maternal and Fetal Outcomes

Natalie A. Bello et al.

Summary: This study compared the effects of using ACC/AHA and ACOG guidelines for defining hypertension in pregnant women. Results showed that using the ACC/AHA criteria led to better identification of women at risk for developing preeclampsia in the future.

JAMA NETWORK OPEN (2021)

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Article Peripheral Vascular Disease

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Jamie A. Kitt et al.

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Sukainah Y. Al Khalaf et al.

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JOURNAL OF THE AMERICAN HEART ASSOCIATION (2021)

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Editorial Material Primary Health Care

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HYPERTENSION (2008)

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