Postpartum trajectory differs by race after hypertensive disorders of pregnancy

There are significant racial differences in postpartum blood pressure trajectories in women with hypertensive disorders of pregnancy, according to a study published online Dec. 22 in JAMA Network Open.

Alisse Hauspurg, M.D., from the University of Pittsburgh School of Medicine, and colleagues assessed the racial differences in blood pressure trajectory in the first six weeks postpartum after a hypertensive disorder of pregnancy. The analysis included 1,077 women (mean age, 30.2 years; 79.1 percent White and 20.9 percent Black) with deliveries from 2018 through 2019.

The researchers found that systolic and diastolic blood pressures decreased rapidly in the first three weeks postpartum, with subsequent stabilization (at six days postpartum: mean peak systolic blood pressure, 146 mm Hg; mean peak diastolic blood pressure, 95 mm Hg; at three weeks postpartum: mean peak systolic blood pressure, 130 mm Hg; mean peak diastolic blood pressure, 85 mm Hg). Both systolic and diastolic blood pressure decreased significantly more slowly among Black women versus White women. At six weeks postpartum, 68.1 percent of Black women met the criteria for stage 1 or stage 2 hypertension versus 51.4 percent of White women.

“This study suggests that postpartum blood pressure trajectories indicate persistence of higher blood pressures among Black women in this cohort, which may have important implications for postpartum morbidity and mortality associated with hypertensive and cardiovascular conditions in this population,” the authors write.