| Title: |
Maternal chronic hypertension in women veterans |
| Authors: |
Harding, Ceshae C.; Goldstein, Karen M.; Goldstein, Sarah A.; Wheeler, Sarahn M.; Mitchell, Nia S.; Copeland, Laurel A. |
| Contributors: |
National Center for Advancing Translational Sciences; Duke University; Health Services Research and Development |
| Source: |
Health Services Research ; volume 59, issue 2 ; ISSN 0017-9124 1475-6773 |
| Publisher Information: |
Wiley |
| Publication Year: |
2024 |
| Collection: |
Wiley Online Library (Open Access Articles via Crossref) |
| Description: |
Objective To describe the prevalence of maternal chronic hypertension (MCH), assess how frequently blood pressure is controlled before pregnancy among those with MCH, and explore management practices for antihypertensive medications (AHM) during the pre‐pregnancy and pregnancy periods. Data Sources, Study Setting, and Study Design We conducted a descriptive observational study using data abstracted from the Veterans Health Administration (VA) inclusive of approximately 11 million Veterans utilizing the VA in fiscal years 2010–2019. Data Collection/Extraction Methods Veterans aged 18–50 were included if they had a diagnosis of chronic hypertension before a documented pregnancy in the VA EMR. We identified chronic hypertension and pregnancy with diagnosis codes and defined uncontrolled blood pressure as ≥140/90 mm Hg on at least one measurement in the year before pregnancy. Sensitivity models were conducted for individuals with at least two blood pressure measurements in the year prior to pregnancy. Multivariable logistic regression explored the association of covariates with recommended and non‐recommended AHMs received 0–6 months before pregnancy and during pregnancy. Principal Findings In total, 8% (3767/46,178) of Veterans with a documented pregnancy in VA data had MCH. Among 2750 with MCH meeting inclusion criteria, 60% ( n = 1626) had uncontrolled blood pressure on at least one BP reading and 31% ( n = 846) had uncontrolled blood pressure on at least two BP readings in the year before pregnancy. For medications, 16% ( n = 437) received a non‐recommended AHM during pregnancy. Chronic kidney disease (OR = 3.2; 1.6–6.4) and diabetes (OR = 2.3; 1.7–3.0) were most strongly associated with use of a non‐recommended AHM during pregnancy. Conclusions Interventions are needed to decrease the prevalence of MCH, improve preconception blood pressure control, and ensure optimal pharmacologic antihypertensive management among Veterans of childbearing potential. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1111/1475-6773.14277 |
| Availability: |
https://doi.org/10.1111/1475-6773.14277; https://onlinelibrary.wiley.com/doi/pdf/10.1111/1475-6773.14277 |
| Rights: |
http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Accession Number: |
edsbas.C41BCA86 |
| Database: |
BASE |