Assessment of Persistent Postpartum Hypertension Following Hypertensive Disorders of Pregnancy: A Scoping Review
7 affiliations
- 1McGill University Health Centre
- 2Research Institute of the McGill University Health Centre
- 3Montreal Children's Hospital
- 4Dalla Lana School of Public Health, University of Toronto
- 5The Hospital for Sick Children
- 6University of Calgary
- 7Centre hospitalier universitaire Sainte‐Justine
Abstract
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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BibTeX
@article{daneshmand2026assessment,
title = {{Assessment of Persistent Postpartum Hypertension Following Hypertensive Disorders of Pregnancy: A Scoping Review}},
author = {Marzieh Daneshmand and Harika Dasari and Lindsay Hales and Naiya Patel and Aya Al‐Katat and Gabriel Altit and Sonia M. Grandi and Kara Nerenberg and Stella S. Daskalopoulou and Isabelle Malhamé},
journal = {Journal of the American Heart Association},
year = {2026},
month = oct,
doi = {10.1161/jaha.126.049749},
url = {https://www.ahajournals.org/doi/10.1161/JAHA.126.049749},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Assessment of Persistent Postpartum Hypertension Following Hypertensive Disorders of Pregnancy: A Scoping Review
AU - Marzieh Daneshmand
AU - Harika Dasari
AU - Lindsay Hales
AU - Naiya Patel
AU - Aya Al‐Katat
AU - Gabriel Altit
AU - Sonia M. Grandi
AU - Kara Nerenberg
AU - Stella S. Daskalopoulou
AU - Isabelle Malhamé
PY - 2026
DA - 2026/10/23
JO - Journal of the American Heart Association
DO - 10.1161/jaha.126.049749
UR - https://www.ahajournals.org/doi/10.1161/JAHA.126.049749
AB - 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.
SN - 2047-9980
ER -