DOI: 10.1161/jaha.126.049749 ISSN: 2047-9980

Assessment of Persistent Postpartum Hypertension Following Hypertensive Disorders of Pregnancy: A Scoping Review

Marzieh Daneshmand, Harika Dasari, Lindsay Hales, Naiya Patel, Aya Al‐Katat, Gabriel Altit, Sonia M. Grandi, Kara Nerenberg, Stella S. Daskalopoulou, Isabelle Malhamé
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Background

Identifying individuals with persistent postpartum hypertension (ppHTN) after hypertensive disorders of pregnancy is an important strategy to mitigate associated long‐term cardiovascular risks. Accordingly, we aimed to review the literature surrounding the assessment of ppHTN after hypertensive disorders of pregnancy.

Methods

We conducted a scoping review using Arksey and O'Malley's methodological framework. We developed and pilot‐tested a data extraction tool to collect information on ppHTN assessment methods, including timing and setting, blood pressure (BP) thresholds used, and inclusion of patient preferences. Data were synthesized into tables and narrative summaries. Barriers and facilitators to BP assessment protocols, remote BP monitoring, and follow‐up attendance were mapped using the Capability, Opportunity, and Motivation ‐ Behavior (COM‐B) framework.

Results

Of 14 593 records, 96 papers met inclusion criteria. BP measured in the hospital alone was most common (n=41), followed by the hospital/home combination (n=18), and the outpatient/home combination (n=9). Monitoring typically began within 0 to 7 days postpartum (n=28), ending at 1 to 6 weeks (n=20) or 6 to 12 months (n=20) postpartum. ppHTN was defined using elevated BP thresholds (n=28), most commonly ≥140/90 mm Hg (n=18), medication initiation (n=8), lack of BP normalization over time (n=4), or referral to a specialist (n=2). Only 7 studies assessed patient preferences. Facilitators to home BP assessment included the use of educational material, while barriers involved digital access limitations.

Conclusions

ppHTN assessment methods varied in timing, setting, and BP thresholds. Findings underscore the need for standardized, patient‐centered guidelines that account for BP assessment methods across settings.

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