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Advances in postpartum hypertension management: a review of current guidelines and interventions

Advances in postpartum hypertension management: a review of current guidelines and interventions
  • O’Kelly, A. C. et al. Pregnancy and reproductive risk factors for cardiovascular disease in women. Circ. Res. 130, 652–672 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Parikh, N. I. et al. Adverse pregnancy outcomes and cardiovascular disease risk: unique opportunities for cardiovascular disease prevention in women: a scientific statement from the American Heart Association. Circulation 143, e902–e916 (2021).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Wu, P. et al. Preeclampsia and future cardiovascular health: a systematic review and meta-analysis. Circ: Cardiovasc. Qual. Outcomes 10, e003497 (2017).

    PubMed 

    Google Scholar 

  • Khosla, K. et al. Long-term cardiovascular disease risk in women after hypertensive disorders of pregnancy: recent advances in hypertension. Hypertension 78, 927–935 (2021).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Garovic, V. D. et al. Hypertension in pregnancy: diagnosis, blood pressure goals, and pharmacotherapy: a scientific statement from the American heart association. Hypertension 79, e21–e41 (2022).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Lewey, J. et al. Opportunities in the postpartum period to reduce cardiovascular disease risk after adverse pregnancy outcomes: a scientific statement from the American Heart Association. Circulation 149, e330–e346 (2024).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Countouris, M. et al. Hypertension in pregnancy and postpartum: current standards and opportunities to improve care. Circulation 151, 490–507 (2025).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Mehta, L. S. et al. Call to action: maternal health and saving mothers: a policy statement from the American Heart Association. Circulation 144, e251–e269 (2021).

    Article 
    PubMed 

    Google Scholar 

  • Brown, H. L. et al. Promoting Risk Identification and Reduction of Cardiovascular Disease in Women Through Collaboration With Obstetricians and Gynecologists: A Presidential Advisory From the American Heart Association and the American College of Obstetricians and Gynecologists. Circulation 137, e843–e852 (2018).

    Article 
    PubMed 

    Google Scholar 

  • Lumsden, R., Page, C. B., Phelan, M., Wheeler, S. & Pagidipati, N. Longitudinal Management of Cardiovascular Risk Factors Among Postpartum Women. J. Womens Health 33, 853–862 (2024).

    Article 
    CAS 

    Google Scholar 

  • Countouris, M. et al. Feasibility of utilizing telehealth in a multidisciplinary postpartum hypertension clinic. Womens Health Rep. 3, 877–886 (2022).

    Google Scholar 

  • Mosca, L. et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women—2011 update: a guideline from the American Heart Association. Circulation 123, 1243–1262 (2011).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Lloyd-Jones, D. M. et al. Life’s essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation 146, e18–e43 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Chen, H. et al. Life’s Essential 8 and cardiovascular disease in women with a history of adverse pregnancy outcomes. Eur. J. Prev. Cardiol. zwaf021, (2025).

  • Crear-Perry, J. et al. Social and structural determinants of health inequities in maternal health. J. Womens Health 30, 230–235 (2021).

    Article 

    Google Scholar 

  • Rokicki, S. et al. Home visits and the use of routine and emergency postpartum care among low-income people: a secondary analysis of a randomized clinical trial. JAMA Netw. Open 7, e2451605 (2024).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Rokicki, S. et al. Impact of nurse home visiting on take-up of social safety net programs in a Medicaid population. Health Aff. Sch. 3, qxaf038 (2025).

    PubMed 
    PubMed Central 

    Google Scholar 

  • Daubert, M. A. et al. Early postpartum blood pressure screening is associated with increased detection of cardiovascular risk factors in women with hypertensive disorders of pregnancy. Am. Heart J. 273, 130–139 (2024).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Cusimano, M. C., Pudwell, J., Roddy, M., Cho, C.-K. J. & Smith, G. N. The maternal health clinic: an initiative for cardiovascular risk identification in women with pregnancy-related complications. Am. J. Obstet. Gynecol. 210, 438.e1–438.e9 (2014).

    Article 
    PubMed 

    Google Scholar 

  • Janmohamed, R. et al. Cardiovascular risk reduction and weight management at a hospital-based postpartum preeclampsia clinic. J. Obstet. Gynaecol. Can. 37, 330–337 (2015).

    Article 
    PubMed 

    Google Scholar 

  • Celi, A. C., Seely, E. W., Wang, P., Thomas, A. M. & Wilkins-Haug, L. E. Caring for women after hypertensive pregnancies and beyond: implementation and integration of a postpartum transition clinic. Matern. Child Health J. 23, 1459–1466 (2019).

    Article 
    PubMed 

    Google Scholar 

  • van der Bijl, M. F. et al. FUPEC study, a prospective open-cohort on severe pre-eclampsia and cardiovascular risk factors based in the Netherlands. BMJ Open 14, e093423 (2024).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Sharma, G. et al. Optimizing psychological health across the perinatal period: an update on maternal cardiovascular health: ascientific statement from the American Heart Association. J. Am. Heart. Assoc. 14, 1–18 (2025).

    Article 

    Google Scholar 

  • Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet. Gynecol. 135, e237–e260 (2020).

  • ACOG Committee Opinion No. 736: Optimizing Postpartum Care. Obstet. Gynecol. 131, e140–e150 (2018).

  • Hauspurg, A. & Jeyabalan, A. Postpartum preeclampsia or eclampsia: defining its place and management among the hypertensive disorders of pregnancy. Am. J. Obstet. Gynecol. 226, S1211–S1221 (2022).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Kitt, J. et al. Long-term blood pressure control after hypertensive pregnancy following physician-optimized self-management: the POP-HT randomized clinical trial. JAMA 330, 1991–1999 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Cairns, A. E. et al. Self-management of postnatal hypertension: the SNAP-HT trial. Hypertension 72, 425–432 (2018).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Kitt, J. et al. Cardiac remodeling after hypertensive pregnancy following physician-optimized blood pressure self-management: the POP-HT randomized clinical trial imaging substudy. Circulation 149, 529–541 (2024).

    Article 
    PubMed 

    Google Scholar 

  • Benschop, L. et al. Blood pressure profile 1 year after severe preeclampsia. Hypertension 71, 491–498 (2018).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Hirshberg, A., Zhu, Y., Smith-McLallen, A. & Srinivas, S. K. Association of a remote blood pressure monitoring program with postpartum adverse outcomes. Obstet. Gynecol. 141, 1163–1170 (2023).

    Article 
    PubMed 

    Google Scholar 

  • Lemon, L. S. et al. Clinical outcomes associated with a remote postpartum hypertension monitoring program. Obstet. Gynecol. 144, 377–385 (2024).

    Article 
    PubMed 

    Google Scholar 

  • Whelton, P. K. et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Hypertension 71, 1269–1324 (2018).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Williams, B. et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur. Heart J. 39, 3021–3104 (2018).

    Article 
    PubMed 

    Google Scholar 

  • Echouffo Tcheugui, J. B., Guan, J., Fu, L., Retnakaran, R. & Shah, B. R. Association of concomitant gestational hypertensive disorders and gestational diabetes with cardiovascular disease. JAMA Netw. Open 5, e2243618 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • ElSayed, N. A. et al. 15. Management of diabetes in pregnancy: standards of care in diabetes—2023. Diab. Care 46, S254–S266 (2023).

    Article 
    CAS 

    Google Scholar 

  • Ratner, R. E. An update on the diabetes prevention program. Endocr. Pr. 12, 20–24 (2006).

    Article 

    Google Scholar 

  • Ratner, R. E. et al. Prevention of diabetes in women with a history of gestational diabetes: effects of metformin and lifestyle interventions. J. Clin. Endocrinol. Metab. 93, 4774–4779 (2008).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Gómez, M. L., Hieronymus, L. B., Ashford, K. B., Barnett, J. M. & Renn, T. A. Linking postpartum and parenting women with a national diabetes prevention program: recruitment efforts, challenges, and recommendations. Diab. Spectr. 31, 324–329 (2018).

    Article 

    Google Scholar 

  • Montes, A. et al. Physiologic and supraphysiologic increases in lipoprotein lipids and apoproteins in late pregnancy and postpartum. Possible markers for the diagnosis of ‘prelipemia’. Arteriosclerosis 4, 407–417 (1984).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Agarwala, A. et al. Dyslipidemia management in women of reproductive potential: An Expert Clinical Consensus from the National Lipid Association. J. Clin. Lipido. 18, e664–e684 (2024).

    Article 

    Google Scholar 

  • Stuebe, A. M. & Rich-Edwards, J. W. The reset hypothesis: lactation and maternal metabolism. Am. J. Perinatol. 26, 81–88 (2009).

    Article 
    PubMed 

    Google Scholar 

  • Grundy, S. M. et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation 139, e1082–e1143 (2019).

    PubMed 

    Google Scholar 

  • Grant, J. K. et al. Lipid-lowering therapy in women of childbearing age: a review and stepwise clinical approach. Curr. Cardiol. Rep. 24, 1373–1385 (2022).

    Article 
    PubMed 

    Google Scholar 

  • Nanna, M. G. et al. Sex differences in the use of statins in community practice: patient and provider assessment of lipid management registry. Circ: Cardiovasc. Qual. Outcomes 12, e005562 (2019).

    PubMed 

    Google Scholar 

  • Klevmoen, M. et al. Loss of statin treatment years during pregnancy and breastfeeding periods in women with familial hypercholesterolemia. Atherosclerosis 335, 8–15 (2021).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Makarem, N. et al. Association of a Mediterranean diet pattern with adverse pregnancy outcomes among US women. JAMA Netw. Open 5, e2248165 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • ACOG Committee Opinion No. 804: Physical Activity and Exercise During Pregnancy and the Postpartum Period: Correction. Obstet. Gynecol. 138, 683–683 (2021).

  • Tobacco and Nicotine Cessation During Pregnancy: ACOG Committee Opinion, Number 807. Obstet. Gynecol. 135, e221–e229 (2020).

  • Rich-Edwards, J. W. et al. Randomized trial to reduce cardiovascular risk in women with recent preeclampsia. J. Womens Health 28, 1493–1504 (2019).

    Article 

    Google Scholar 

  • Lewey, J. et al. Effectiveness of a text-based gamification intervention to improve physical activity among postpartum individuals with hypertensive disorders of pregnancy: a randomized clinical trial. JAMA Cardiol. 7, 591–599 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Kim, D. S., Eltahir, A. A., Ngo, S. & Rodriguez, F. Bridging the gap: how accounting for social determinants of health can improve digital health equity in cardiovascular medicine. Curr. Atheroscler. Rep. 27, 9 (2024).

    Article 
    PubMed 

    Google Scholar 

  • Powell-Wiley, T. M. et al. Role of technology in promoting heart healthy behavior change to increase equity in optimal cardiovascular health: a scientific statement from the American Heart Association. Circulation 151, e972–e985 (2025).

    Article 
    PubMed 

    Google Scholar 

  • Kókai, L. L. et al. Needs and preferences of women with prior severe preeclampsia regarding app-based cardiovascular health promotion. BMC Womens Health 22, 427 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Ogunwole, S. M., Zera, C. A. & Stanford, F. C. Obesity management in women of reproductive age. JAMA 325, 433–434 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Jastreboff, A. M. et al. Tirzepatide once weekly for the treatment of obesity. N. Engl. J. Med. 387, 205–216 (2022).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Lincoff, A. M. et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N. Engl. J. Med. 389, 2221–2232 (2023).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Pi-Sunyer, X. et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N. Engl. J. Med. 373, 11–22 (2015).

    Article 
    PubMed 

    Google Scholar 

  • Sharma, G. Treating reproductive-aged women with glucagon-like peptide-1 receptor agonists: what are the clinical considerations?. Circulation 150, 1487–1489 (2024).

    Article 
    PubMed 

    Google Scholar 

  • Drummond, R. F., Seif, K. E. & Reece, E. A. Glucagon-like peptide-1 receptor agonist use in pregnancy: a review. Am. J. Obstet. Gynecol. 232, 17–25 (2025).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Dao, K. et al. Use of GLP1 receptor agonists in early pregnancy and reproductive safety: a multicentre, observational, prospective cohort study based on the databases of six Teratology Information Services. BMJ Open 14, e083550 (2024).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Cesta, C. E. et al. Safety of GLP-1 receptor agonists and other second-line antidiabetics in early pregnancy. JAMA Intern. Med. 184, 144–152 (2024).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Imbroane, M. R., LeMoine, F. & Nau, C. T. Preconception glucagon-like peptide-1 receptor agonist use associated with decreased risk of adverse obstetrical outcomes. Am. J. Obstet. Gynecol. S0002937825000419; (2025).

  • Schwarz, E. B. et al. Duration of lactation and risk factors for maternal cardiovascular disease. Obstet. Gynecol. 113, 974–982 (2009).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Obstetric Care Consensus No. 8: Interpregnancy Care. Obstet Gynecol 133, e51–e72; (2019).

  • Lindley, K. J. et al. Contraception and reproductive planning for women with cardiovascular disease: JACC focus seminar 5/5. J. Am. Coll. Cardiol. 77, 1823–1834 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Miller, H. E. et al. Addressing postpartum contraception practices utilizing a multidisciplinary Pregnancy Heart Team approach. AJOG Glob. Rep. 2, 100100 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Murugappan, G., Alvero, R. J., Lyell, D. J., Khandelwal, A. & Leonard, S. A. Development and validation of a risk prediction index for severe maternal morbidity based on preconception comorbidities among infertile patients. Fertil. Steril. 116, 1372–1380 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Leonard, S. A., Kennedy, C. J., Carmichael, S. L., Lyell, D. J. & Main, E. K. An expanded obstetric comorbidity scoring system for predicting severe maternal morbidity. Obstet. Gynecol. 136, 440–449 (2020).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Powell-Wiley, T. M. et al. Social determinants of cardiovascular disease. Circ. Res. 130, 782–799 (2022).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Hurwitz, M., Bonomo, J., Spitz, J. & Sharma, G. Intersectionality and social drivers of health in cardiovascular care. Methodist Debakey Cardiovasc. J. 20, 98–110 (2024).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Keith, M. H. & Martin, M. A. Social determinant pathways to hypertensive disorders of pregnancy among nulliparous U.S. women. Womens Health Issues 34, 36–44 (2024).

    Article 
    PubMed 

    Google Scholar 

  • Sharma, G. et al. Social determinants of suboptimal cardiovascular health among pregnant women in the United States. J. Am. Heart Assoc. 11, e022837 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Chen, M., Tan, X. & Padman, R. Social determinants of health in electronic health records and their impact on analysis and risk prediction: a systematic review. J. Am. Med. Inf. Assoc. 27, 1764–1773 (2020).

    Article 

    Google Scholar 

  • White-Williams, C. et al. Addressing social determinants of health in the care of patients with heart failure: a scientific statement from the American Heart Association. Circulation 141, e841–e863 (2020).

    Article 
    PubMed 

    Google Scholar 

  • Lindley, K. J. et al. Socioeconomic determinants of health and cardiovascular outcomes in women. J. Am. Coll. Cardiol. 78, 1919–1929 (2021).

    Article 
    PubMed 

    Google Scholar 

  • Metlock, F. E. et al. Impact of social determinants of health on hypertension outcomes: a systematic review. Hypertension 81, 1675–1700 (2024).

    Article 
    CAS 
    PubMed 

    Google Scholar 

  • Churchwell, K. et al. Call to action: structural racism as a fundamental driver of health disparities: a presidential advisory from the American Heart Association. Circulation 142, e454–e468 (2020).

    Article 
    PubMed 

    Google Scholar 

  • Caropreso, L., De Azevedo Cardoso, T., Eltayebani, M. & Frey, B. N. Preeclampsia as a risk factor for postpartum depression and psychosis: a systematic review and meta-analysis. Arch. Womens Ment. Health 23, 493–505 (2020).

    Article 
    PubMed 

    Google Scholar 

  • Roberts, L., Henry, A., Harvey, S. B., Homer, C. S. E. & Davis, G. K. Depression, anxiety and posttraumatic stress disorder six months following preeclampsia and normotensive pregnancy: a P4 study. BMC Pregnancy Childbirth 22, 108 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum: ACOG Clinical Practice Guideline No. 4. Obstet. Gynecol. 141, 1232–1261 (2023).

  • ACOG Committee Opinion No. 757: Screening for Perinatal Depression. Obstet. Gynecol. 132, e208–e212 (2018).

  • Baattaiah, B. A. et al. The relationship between fatigue, sleep quality, resilience, and the risk of postpartum depression: an emphasis on maternal mental health. BMC Psychol. 11, 10 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Lewis, B. A., Gjerdingen, D., Schuver, K., Avery, M. & Marcus, B. H. The effect of sleep pattern changes on postpartum depressive symptoms. BMC Womens Health 18, 12 (2018).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Smolderen, K. G. et al. The role of the clinical psychologist in the care of adults with cardiovascular disease. JACC Adv. 3, 100910 (2024).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Sanghavi, M. et al. Telemedicine may increase visit completion rates in postpartum patients with preeclampsia. PLoS One 17, e0275741 (2022).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Hauspurg, A. et al. A postpartum remote hypertension monitoring protocol implemented at the hospital level. Obstet. Gynecol. 134, 685–691 (2019).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Ladeiras-Lopes, R. et al. Social media in cardiovascular medicine: a contemporary review. Eur. Heart J. Digit Health 1, 10–19 (2020).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  • Cameron, N. A. et al. An enhanced postpartum transition program to primary care. J. Womens Health 33, 1417–1422 (2024).

    Article 

    Google Scholar 

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