Poster Session 2
Jenny Y. Mei, MD (she/her/hers)
Clinical Assistant Professor
Stanford University
Mountain View, California, United States
Audra Fain, MD (she/her/hers)
Resident Physician
University of California, Los Angeles
Los Angeles, California, United States
Kate Corry-Saavedra, MD
Resident Physician
University of California, Irvine
University of California, Irvine, California, United States
Tina A. Nguyen, MD
Assistant Professor
University of California, Los Angeles
Los Angeles, California, United States
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Thalia Mok, MD
Assistant Professor
University of California, Los Angeles
Los Angeles, California, United States
Aisling M. Murphy, MD
Assistant Professor
University of California, Los Angeles
Los Angeles, California, United States
With more institutions implementing lower blood pressure (BP) targets prior to postpartum discharge for patients with hypertensive disorders of pregnancy, a growing number of patients are discharged on anti-hypertensive (anti-HTN) medication. We aim to evaluate risk factors associated with being discharged on anti-HTN medication with lower BP goals.
Study Design:
A retrospective cohort study of birthing patients with peripartum hypertension (HTN) at a quaternary care center over 2 years. This study is part of an ongoing postpartum quality improvement project that entails lower BP targets and universal remote BP monitoring. Goal blood pressure was under 140/90 leading up to discharge. Inclusion criteria were delivery at the study institution and diagnosis of HTN disorder of pregnancy. Primary outcome was prescription of anti-HTNs at time of discharge. Characteristics associated with discharge on anti-HTNs were compared between groups.
Results:
Out of 6410 deliveries between April 2022-April 2024, 2019 (31.5%) pregnancies met inclusion criteria, of which 666 (33.0%) were discharged on anti-HTN medication. Baseline characteristics associated with discharge on anti-HTN included maternal age 40 and above (17.0% vs 11.8%, p=0.001), non-Hispanic Black race (13.7% vs 9.5%, p=0.005), chronic HTN (28.4% vs 12.3%, p< 0.001), prenatal aspirin use (52.1% vs 33.6%, p< 0.001), and having public or no insurance (25.2% vs 19.7%, p=0.005). Other risk factors for discharge on anti-HTN medication include proteinuria (43.2% vs 23.6%, p< 0.001) and preeclampsia with severe features (40.4% vs 5.1%, p< 0.001). Patients discharged on anti-HTNs were more likely to be compliant with remote BP monitoring (97% vs 94.2%, p=0.013) and undergo outpatient medication adjustments (24.6% vs 14.5%, p< 0.001).
Conclusion:
At an institution implementing lower BP targets aiming for normotension, certain traditional high-risk patients remain at increased risk for discharge on anti-HTN medication. Continued research is needed to identify ways of mitigating long-term comorbidities for this high-risk cohort.
