TOPLINE:

Women with hypertensive disorders of pregnancy (HDP) who received antihypertensive treatment in the early postpartum period had a higher risk of developing chronic hypertension and other cardiovascular complications over 10 years than those who did not receive treatment.

METHODOLOGY:

• Using a linked national database in France, researchers conducted a population-based nationwide cohort study to evaluate whether early postpartum antihypertensive treatment was associated with differences in subsequent cardiovascular outcomes.
• The study included 108,906 women with HDP who gave birth between 2010 and 2014. Of these, 35,878 women received at least one antihypertensive medication in the month following discharge (mean maternal age, 30.98 years) and 73,028 did not receive such treatment during this period (mean maternal age, 29.61 years).
• The main outcome was chronic hypertension, identified by three consecutive courses of antihypertensive treatment or hospital admissions coded using standardised codes.
• Women were followed up for 10 years after childbirth.

TAKEAWAY:

• At 10 years, 43.92% of women who received antihypertensive treatment in the early postpartum period developed chronic hypertension compared with 18.39% of those who did not receive treatment.
• Women who received early postpartum antihypertensive treatment had a higher 10-year risk of developing chronic hypertension than those who did not receive treatment (adjusted hazard ratio [aHR], 3.067; 95% CI, 2.996-3.139). A similarly elevated risk was observed for composite outcomes including and excluding chronic hypertension.
• The risks for heart failure, coronary heart disease, and cerebrovascular disease were also higher with antihypertensive treatment than without such treatment (aHR, 1.682; 95% CI, 1.351-2.096; aHR, 1.436; 95% CI, 1.167-1.767; and aHR, 1.406; 95% CI, 1.210-1.632, respectively).
• The risk for chronic hypertension was highest within 3 months after maternity discharge among women treated with antihypertensive medications.

IN PRACTICE:

"These findings support the need for new evidence-based strategies to guide postpartum hypertension management, including surveillance protocols and treatment pathways," the authors wrote.

"As clinical practices evolve, particularly considering recent trial data, our study provides a benchmark against which to assess future improvements in postpartum cardiovascular care," they added.

SOURCE:

The study was led by Emmanuel Simon, Université Bourgogne Europe, CHU Dijon Bourgogne, Service d'obstétrique et de gynécologie, Dijon, France. It was published online on April 22, 2026, in BJOG: An International Journal of Obstetrics & Gynaecology.

LIMITATIONS:

The study lacked data on ethnicity for each patient in France. The observational nature of the study may have introduced confounding by indication. Treatment exposure was defined using pharmacy dispensing data, which may not have captured patient adherence and compliance.

DISCLOSURES:

This study received support from the Agence Régionale de Santé Bourgogne Franche Comté. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.